Treatment and outcome of hepatorenal syndrome in Japan: a retrospective cohort study using a national inpatient database.
Humans
Male
Aged
Female
Hepatorenal Syndrome
/ epidemiology
Inpatients
Japan
/ epidemiology
Dopamine
/ therapeutic use
Retrospective Studies
Carcinoma, Hepatocellular
/ therapy
Vasoconstrictor Agents
/ therapeutic use
Liver Cirrhosis
/ drug therapy
Norepinephrine
/ therapeutic use
Liver Neoplasms
/ therapy
Treatment Outcome
Albumins
Peritonitis
/ complications
Hepatorenal syndrome
Liver cirrhosis
Renal insufficiency
Journal
BMC gastroenterology
ISSN: 1471-230X
Titre abrégé: BMC Gastroenterol
Pays: England
ID NLM: 100968547
Informations de publication
Date de publication:
23 Jun 2023
23 Jun 2023
Historique:
received:
01
03
2023
accepted:
18
06
2023
medline:
26
6
2023
pubmed:
24
6
2023
entrez:
23
6
2023
Statut:
epublish
Résumé
Hepatorenal syndrome (HRS) is a life-threatening complication of end-stage liver disease. This study aimed to clarify the status of HRS in Japan by analyzing the Japanese Diagnosis Procedure Combination database. Patients hospitalized for cirrhosis and HRS from July 2010 to March 2019 were sampled. They were divided into two groups according to their prognosis upon discharge: the transplant-free survival group and the death or liver transplantation group. The two groups' baseline patient characteristics and treatments were compared. The mean age of the 1,412 participants was 67.3 years (standard deviation: 12.3 years), and 65.4% were male. The Child-Pugh grades was B and C in 18.8% and 81.2%, respectively. Hepatocellular carcinoma was present in 27.1% of the patients, and the proportion of spontaneous bacterial peritonitis was 2.3%. Albumin, noradrenaline, and dopamine were administered to 57.9%, 8.0%, and 14.9% of the patients, respectively; 7.0% of the patients underwent renal replacement therapy; and 5.0% were admitted to the intensive care unit. Intravenous antibiotics were administered to 30.8% of the patients. A total of 925 patients (65.5%) died or underwent liver transplantation. In addition to a higher proportion of patients with poor baseline liver function, the death or liver transplantation group included more males, patients with hepatocellular carcinoma, and those with spontaneous bacterial peritonitis. HRS in Japan has a high mortality rate. Albumin was administered to over 50% of participants. Although noradrenaline is recommended in Japanese clinical guidelines, dopamine was more frequently used as a vasoconstrictor in clinical practice.
Sections du résumé
BACKGROUND
BACKGROUND
Hepatorenal syndrome (HRS) is a life-threatening complication of end-stage liver disease. This study aimed to clarify the status of HRS in Japan by analyzing the Japanese Diagnosis Procedure Combination database.
METHODS
METHODS
Patients hospitalized for cirrhosis and HRS from July 2010 to March 2019 were sampled. They were divided into two groups according to their prognosis upon discharge: the transplant-free survival group and the death or liver transplantation group. The two groups' baseline patient characteristics and treatments were compared.
RESULTS
RESULTS
The mean age of the 1,412 participants was 67.3 years (standard deviation: 12.3 years), and 65.4% were male. The Child-Pugh grades was B and C in 18.8% and 81.2%, respectively. Hepatocellular carcinoma was present in 27.1% of the patients, and the proportion of spontaneous bacterial peritonitis was 2.3%. Albumin, noradrenaline, and dopamine were administered to 57.9%, 8.0%, and 14.9% of the patients, respectively; 7.0% of the patients underwent renal replacement therapy; and 5.0% were admitted to the intensive care unit. Intravenous antibiotics were administered to 30.8% of the patients. A total of 925 patients (65.5%) died or underwent liver transplantation. In addition to a higher proportion of patients with poor baseline liver function, the death or liver transplantation group included more males, patients with hepatocellular carcinoma, and those with spontaneous bacterial peritonitis.
CONCLUSIONS
CONCLUSIONS
HRS in Japan has a high mortality rate. Albumin was administered to over 50% of participants. Although noradrenaline is recommended in Japanese clinical guidelines, dopamine was more frequently used as a vasoconstrictor in clinical practice.
Identifiants
pubmed: 37353737
doi: 10.1186/s12876-023-02858-5
pii: 10.1186/s12876-023-02858-5
pmc: PMC10288750
doi:
Substances chimiques
Dopamine
VTD58H1Z2X
Vasoconstrictor Agents
0
Norepinephrine
X4W3ENH1CV
Albumins
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
218Subventions
Organisme : The Ministry of Health, Labour and Welfare, Japan
ID : 21AA2007 and 22AA2003
Organisme : The Ministry of Education, Culture, Sports, Science and Technology, Japan
ID : 20H03907
Organisme : Health, Labour and Welfare Policy Research Grants from the Ministry of Health, Labour and Welfare, Japan
ID : Policy Research for Hepatitis Measures [H30-Kansei-Shitei-003]
Informations de copyright
© 2023. The Author(s).
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