Imran Taqi, Saeed-uz Zaman, Yousuf Jamal, Yasir Ali, Muhammad Azam.
Frequency of Acute Renal Failure (ARF) in patients of Liver Cirrhosis Presented with Hemetemesis and/or Melena.
Pak J Med Health Sci Jan ;12(4):1716-9.

Background: Patients with liver cirrhosis commonly present with renal dysfunction due to decreased clearance of free water with the end result of sodium and water retention 1. Acute renal failure is particularly common in patients of liver cirrhosis who present with hemetemesis and/or melena , leading to bad prognosis in these patients. 2 Aim : To determine the frequency of acute Renal Failure (ARF) in patients of liver cirrhosis presented with hemetemesis and / or melena. Methods: This Descriptive Case Series study was done in Medicine Department, Services Hospital Lahore. A total of 128 patients of liver cirrhosis who presented with hemetemesis and /or melena were enrolled. Serum creatinine levels were assessed and abdominal ultrasound with particular emphasis on kidney, ureter and bladder (K.U.B) examination was also done. Liver disease was assessed for severity by Child-Pugh scores. Patients having Acute renal failure were treated as per hospital protocol. Data was analyzed by using SPSS version 23.0. Data were stratified for age, gender and child-pugh class to deal with effect modifiers. After stratification, Chi-Square test was used, taking p-value ≤0.05 as significant . Results: Frequency of Acute renal failure (ARF) in patients of liver cirrhosis presented with hemetemesis and/melena was 82( 64.1% ). Significant association of Acute Renal failure with Child-Pugh Class was also noted. Conclusion: Acute Renal Failure is a common finding in patients with liver cirrhosis presented with hemetemesis and/or melena, the occurrence of which is mainly related to the severity of upper gastrointestinal bleeding and baseline liver function.

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