Interplay of Cardiac and Renal Dysfunction with Disease Severity in Cirrhosis: A Prospective Cross-Sectional Study
DOI:
https://doi.org/10.66328/ijprmh.2025.010203Keywords:
Cirrhosis, Diastolic dysfunction, Renal Impairment, Cardio-renal Interaction, Child–Pugh ClassificationAbstract
Introduction: Cirrhosis is a multisystem disorder characterized by hepatic fibrosis, portal hypertension, and progressive extrahepatic organ involvement. Cardiac dysfunction and renal impairment significantly influence prognosis but remain under-characterized in North Indian populations. This study evaluated the etiological spectrum of cirrhosis and assessed the prevalence and interrelationship of cardiac and renal dysfunction across disease severity.
Methods: A prospective cross-sectional study was conducted at a tertiary care centre in Amritsar (October 2023–January 2025). Eighty clinically and radiologically confirmed cirrhotic patients were enrolled. Clinical examination, biochemical evaluation, viral screening, Doppler ultrasonography, ECG, and transthoracic echocardiography were performed. Disease severity was classified by Child–Pugh criteria. Renal dysfunction was assessed using estimated glomerular filtration rate (eGFR). Statistical analyses were performed using SPSS v21 with significance set at p≤0.05.
Results: Alcoholic liver disease was the leading etiology (45%), followed by hepatitis B (25.8%) and NAFLD (17.5%). Half of the cohort belonged to Child–Pugh class B. Diastolic dysfunction was detected in 56.9% of patients, most commonly Grade I. Renal impairment (eGFR <60 mL/min/1.73m²) was present in 19.3%. Both cardiac and renal dysfunctions showed increasing prevalence with advancing Child–Pugh class. A significant association was observed between reduced left ventricular ejection fraction and lower eGFR values (p=0.017), indicating interdependence of cardiac and renal compromise.
Conclusion: Cirrhosis in this population is predominantly alcohol-related, with substantial cardiac and renal involvement that intensifies with disease severity. Integrated evaluation of cardio-renal function is essential for prognostication and timely management. Larger multicentre longitudinal studies are warranted to refine risk stratification.
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