Managing severe alcoholic hepatitis complicated by renal failure

Abstract

We examined the management and outcome of 15 patients admitted consecutively to a specialist Liver Unit with severe alcoholic hepatitis complicated by renal failure. Fourteen patients were managed conservatively. Of these, 11/14 underwent renal dialysis for a mean of 24 days. Three patients, including two requiring dialysis, recovered renal function. Despite intensive care, 12/14 patients died. Death was frequently associated with bacterial and fungal sepsis.

One patient underwent liver transplantation with prompt post-operative recovery of renal function. He was discharged from hospital 16 days later, and remains abstinent from alcohol with normal liver function after one year.

Most patients with renal failure complicating severe alcoholic hepatitis will die, despite intensive care including renal dialysis. Selected patients may be suitable for liver transplantation.