Background and study aims: Renal dysfunction is a common and serious problem in patients with
advanced liver disease. The study aims to assess the incidence, risk factors and short-term prognosis of
renal failure after upper-gastrointestinal bleeding among cirrhotic patients in Upper Egypt.
Methods: We recruited 159 cirrhotic patients with 168 episodes of upper-gastrointestinal bleeding from
Tropical Medicine and Gastroenterology Department, Assiut University Hospital. For all participants, the
following were conducted: clinical evaluation, abdominal ultrasonography (US) examination, laboratory
investigations and upper endoscopy. Risk factors of renal failure were identified using univariate, then
multivariate analysis.
Results: The incidence of renal failure among bleeding episodes was 28%. Higher risk of renal failure
among cirrhotic patients with upper-gastrointestinal bleeding was observed with shock (odds ratio
(OR) 0.171, 95% confidence interval (CI) 0.047:0.624), bacterial infection (OR 0.310, 95% CI 107:897),
Child-Pugh class C (OR 2.79, 95% CI 1.018:7.62), higher serum bilirubin (OR 0.122, 95% CI 0.000:0.002)
lower serum albumin (OR 0.188, 95% CI 0.288:0.056) and raised baseline blood urea (OR 0.181,
95% CI 0.003:0.017) and serum creatinine (OR 0.533, 95% CI 0.002:0.004). Mortality among patients with renal failure was 31.9%.
Conclusion: Renal failure is a frequent event among cirrhotic patients with upper-gastrointestinal bleeding
and there are many contributing factors for its development. Mortality is relatively high among
patients with renal failure in cirrhotics with upper-gastrointestinal bleeding.