Renal Function Changes in Cirrhosis of the Liver

Thirteen patients with cirrhosis had sequential studies of renal function done as their clinical state deteriorated or improved; four others were studied as renal failure developed. While some patients with severe liver disease had an increase in renal function when their condition improved, renal function bore no consistent relation to clinical severity, changes in water and sodium excretion rates were not consistently accompanied by changes in glomerular filtration rate, and cardiac output did not change consistently with the clinical state. These discrepancies indicate that the cause or causes of the abnormalities in renal function do not correlate consistently with guides generally employed to estimate clinical severity, and suggest that the observed alterations in renal function may not have a single pathogenesis. There was no apparent way to distinguish which of the decompensated patients would develop renal failure.