Hepatic and Renal Features in Sepsis: Etiological, Clinical and Laboratory Correlations

Hepatorenal syndrome (HRS) occurring in sepsis has become an accepted approach since 2007, type I HRS being especially characteristic to alterations occurring in sepsis. This study aimed to find associations between elements pertaining to the microbiological, clinical and biochemical aspects in patients with hepatic and/or renal dysfunctions and HRS in sepsis. A total of 117 patients with sepsis were included in the study, patients that had been admitted in the Infectious Disease Clinical Hospital in Iasi, Romania, across a period of 17 months, from November 2012 to April 2014, presenting with or developing hepatic or renal functional disorders, HRS, and other organ dysfunctions. We have carried out a statistical analysis of paraclinical parameters in the context of clinical modifications. Thus, we have identified a series of statistical correlations between the levels of serum creatinine and the degree of severity in sepsis, and also between total bilirubin level and altered neurological status (coma, confusional state). Using the ROC curve analysis, the optimal cut-off values for ALT, AST and total bilirubin were set at 78 IU/L, 75.5 IU/L, and 25.5 mg%, respectively, while the Quick Index showed a cut-off value of 66%, in an inversely proportion relationship with unfavourable evolution of liver disease.