Vol. 4, Issue 4, Part F (2018)

Aims and Objectives: To calculate and compare RI in patients of compensated and decompensated cirrhosis and its prognostic significance.

Materials and Methods: Hundred liver cirrhosis patients were studied in J.A. Group of Hospitals, Gwalior from November 2014 to September 2016. Study cohort was divided into Group A (patients with compensated liver cirrhosis), Group B (patients with decompensated cirrhosis responsive to diuretics), Group C (patients with decompensated cirrhosis resistant to diuretics) and Group D (patients with hepatorenal syndrome). Child Pugh Score was used to classify cirrhosis of liver as Grade A (Total score of 5–6; well compensated disease), Grade B (Total score of 7–9; disease with significant functional compromise) and Grade C (Total score of 10–15; decompensated liver disease).

Results: Most of the patients were male (84%) with mean age of 45.34±13.98 years. In patients with compensated and decompensated cirrhosis mean RI value was 0.56 and0.69 respectively. Out of 3 compensated cirrhosis patients none had RI >0.7 whereas out of 97 decompensated cirrhosis patients 44.33% patients had RI > 0.7 (P >0.05). In Group A, most of the patients had RI <0.60 (n=2; 66.67%), in Group B, most of them had RI range 0.61-0.70 (n=23; 46%), in Group C, most of them had RI range 0.71-0.80 (n=23; 67.64%) and in Group D, most of the patients had RI range >0.80 (n=8; 61.54%) (p<0.05).Out of 27 patients with blood urea ≥ 40, 66.67% patients had RI >0.7 (P<0.05) and out of 24 patients with serum creatinine ≥ 1.5, 70.83% patients were having RI > 0.7 (P< 0.05). Out of 57 patients who had RI <0.7, 2 (3.51%) patients expired whereas out of 43 patients who had RI >0.7, 10 (23.25%) patients expired.

Conclusion: RI increases with degree of hepatic decompensation. Higher value of RI helps in early detection of subsequent kidney dysfunction, and hepatorenal syndrome. Mortality was higher in patients having RI >0.7.