Hepatorenal Dysfunction in Sepsis: Etiological, Clinical and Laboratory Correlations
Hepatorenal syndrome (HRS) in sepsis has become an accepted approach since 2007, type I HRS being particularly characteristic of modifications occurring in sepsis. The aim of this study was to identify correlations between the microbiological, clinical and biochemical elements in patients with hepatic/ renal dysfunctions and HRS in sepsis. The study included 117 patients with sepsis, admitted in the Infectious Disease Clinical Hospital in Iasi, Romania, from November 2012 to April 2014, patients who presented with or developed hepatic or renal dysfunction, HRS, and other organ dysfunctions. A statistical analysis of paraclinical parameters was carried out in the context of clinical modifications. We have identified statistical correlations between serum creatinine level and the degree of severity in sepsis, as well as between total bilirubin level and altered neurological status (coma, confusional state). Using ROC curve analysis, the optimal cut-off values for ALT, AST and total bilirubin were set at 78 IU/L, 75.5 IU/L and 25.5 mg %, respectively, while the Quick Index, in an inversely proportion relationship with unfavourable evolution of liver disease, had a cutoff value of 66%.
Codrina Bejan*, Egidia Miftode, Lucian Boiculese and Carmen Dorobat