No kidney improvement after dialysis in cirrhosis. Why?

Question

Hi doctor,

My father is suffering from liver cirrhosis as reported by the doctors. His kidneys are also damaged and due to constipation brain is also getting affected. Urine is not passing. He is unconscious. We tried dialysis twice but there are no signs of improvement as per the doctors here. I just wanted to have another opinion regarding his survival. Any experienced doctor's advice would help a lot in this situation. He is an alcoholic since last 20 years.

Answer 1

Hello,

Welcome to icliniq.com.

As described in the case summary, the patient's condition is critical (attachment removed to protect patient identity). Decompensated cirrhosis is an irreversible disease, and it seems the patient has all the complications of the disease. The optimum medical management is already being provided as per the summary. Liver transplant is the only curative option but with the current situation, at least some partial recovery would be perhaps needed before the transplant can be taken up particularly for kidneys. Logistics and donor from family are needed for transplant to proceed as LDLT is an option. The patient is too sick to wait for a cadaveric donor. It seems it would be prudent to continue treatment as of now. The chances of survival will depend on the recovery signs best judged by the treating doctor.