Incidence and characteristics of type 2 hepatorenal syndrome in patients with cirrhosis and refractory ascites.

BACKGROUND AND AIM: Type 2 hepatorenal syndrome (HRS) is a well described progressive impairment of renal function in patients with cirrhosis but its natural history, especially in patients with refractory ascites, is not well known. The aim of this study was to assess the incidence, predictive factors and outcome of type 2 HRS in patients with cirrhosis and refractory ascites.

PATIENTS AND METHODS: Thirty patients with refractory ascites were followed-up for 17.5 +/- 26.3 months. The clinical characteristics, biological findings and outcome were analysed. The occurrence of renal dysfunction, and type 2 HRS in particular, was systematically analysed.

RESULTS: Twenty-five patients (83.3%) developed renal dysfunction. Type 2 HRS was diagnosed in 16 patients (53.3%). Patients with type 2 HRS were older than patients without (64.8 +/- 9.1 yr vs 52.8 +/- 9.0 yr ; p < 0.001). All the others studied variables were similar between type 2 HRS and non-type 2 HRS patients. There was no significant difference in the overall probability of survival between these 2 groups.

CONCLUSIONS: In patients with cirrhosis and refractory ascites, the development of type 2 HRS is frequent but does not occur in more severe liver disease and does not affect prognosis.