Adrenal Insufficiency in Cirrhotics With Ascites. Effects of Hydrocortisone on Renal and Haemodynamic Function

Adrenal Insufficiency in Cirrhotics With Ascites. Effects of Stress Doses of Hydrocortisone on Renal Function and on Liver and Systemic Haemodynamics

Relative adrenal insufficiency (RAI) is an well known condition in patients with septic shock. Liver failure (including chronic liver failure)and sepsis are both characterized by hyperdynamic circulatory failure (with low arterial pressure) and high levels of pro-inflammatory cytokines.

Hydrocortisone has been shown to have a beneficial effect on clinical outcome. The aim of this study is to evaluate the incidence of RAI in the different settings of ascites in cirrhosis and the usefulness of hydrocortisone in this context.

Inclusion Criteria:

• Cirrhosis with ascites, with or without hepatorenal syndrome

Exclusion Criteria:

• Age < 18 and > 75 years
• Shock or bacterial infection present at the inclusion or during the previous week
• Bleeding present at the inclusion or during the previous week
• Multifocal HCC
• Organic renal failure
• Hearth or pulmonary failure