Association between Malnutrition and the Development of Hepatorenal Syndrome in Patients with Liver Cirrhosis: A Prospective Observational Study

Abstract

Objective: This study aimed to understand the prevalence of hepatorenal syndrome in malnourished patients with liver cirrhosis and identify nutrition-related risk factors associated with its development. Methods: This retrospective study included 385 cirrhosis patients with signs of malnutrition admitted between January 2018 and December 2023. Patients were classified based on body mass index (BMI) and serum albumin level. HRS was diagnosed based on the International Ascites Club criteria [7, 8]. Data on demographics, etiology, disease severity, laboratory parameters, and clinical outcomes were collected from medical records. Data were statistically analyzed for descriptive and multivariate parameters using SPSS software 23.0. Results: The prevalence of HRS in the population with chronic malnutrition was 24.15%. HRS was significantly higher in severely malnourished patients with a BMI of 16.0 kg/m2 and albumin level of 2.8 g/dL (76.34%) than in mildly malnourished patients. A multivariate investigation revealed that a low body mass index (OR=2.5, 95% CI: 1.5-4.1) and low serum albumin (OR=3.2, 95% CI: 1.8-6.0) were independent risk factors for the development of HRS. Conclusion: The study findings highlight the importance of nutritional support in the management of patients with cirrhosis to prevent the development of HRS. Further prospective studies are needed to validate our results and explore the potential mechanisms underlying the association between malnutrition and hepatorenal syndrome.