Renal Dysfunction In Chronic Liver Disease: A Cross-Sectional Analysis Of Prevalence, Etiology, And Biomarker Correlations At A Tertiary Care Center In Western India

Abstract

Background & Aims: Renal dysfunction constitutes a serious complication in chronic liver disease (CLD), significantly increasing mortality. While the hemodynamic mechanisms are established, population-specific data on prevalence, etiological spectrum, and biomarker correlates remain limited in Western Indian contexts. This study aimed to characterize renal dysfunction in CLD patients at a tertiary care center in Bhavnagar, India.

Methods: In this cross-sectional study, we enrolled 127 consecutive CLD patients meeting inclusion criteria between January and June 2023. Renal dysfunction was defined as serum creatinine ≥1.5 mg/dL or 24-hour urine output <500 mL. Comprehensive clinical, demographic, and laboratory parameters were analyzed using appropriate statistical methods.

Results: The cohort demonstrated male predominance (94%) with mean age 47.7±12.6 years. Alcoholic liver disease was the predominant etiology (80.3%). Renal dysfunction prevalence was 33.9%, with upper gastrointestinal hemorrhage (51.2%) and infections (35.4%) as leading precipitants. Significant biomarker abnormalities included elevated serum bilirubin >2 mg/dL (69.3%), hypoalbuminemia <3.2 g/dL (49.6%), elevated serum creatinine >1.4 mg/dL (33.9%), and hyponatremia <135 mmol/L (19.7%). Hypoalbuminemia was significantly associated with infection-related renal dysfunction (81.4% versus 26.2% in hemorrhage-related cases, p<0.001).

Conclusion: Renal dysfunction is a prevalent complication in decompensated CLD, with distinct regional etiological patterns and biomarker correlates. Proactive renal surveillance and etiology-specific management strategies are imperative for improving outcomes in this population.