THE IMPACT OF HEPATORENAL SYNDROME AND ANEMIA ON CLINICAL OUTCOMES

Abstract

Hepatorenal syndrome (HRS) represents a severe complication in patients with advanced liver cirrhosis, characterized by rapid deterioration of renal function in the absence of structural kidney disease. While the pathophysiology of HRS has been extensively studied, the role of concomitant anemia as a potential prognostic factor remains inadequately characterized. This thesis investigates the relationship between anemia severity and clinical outcomes in patients with hepatorenal syndrome, examining both type 1 and type 2 HRS presentations. Through retrospective analysis of clinical data from 287 patients diagnosed with HRS between 2022-2024, this study evaluates hematological parameters, renal function markers, and survival outcomes. Results demonstrate that lower hemoglobin levels (<9 g/dL) are independently associated with increased 30-day mortality (HR 1.87, 95% CI 1.42-2.46, p<0.001) and reduced response to vasoconstrictor therapy. Furthermore, correction of anemia through targeted interventions was associated with improved renal recovery metrics. These findings establish anemia as a significant and potentially modifiable prognostic factor in HRS, suggesting that management protocols should incorporate hematological optimization alongside standard vasoconstrictive therapies to improve patient outcomes.