A clinical audit on the management of children with hepatorenal syndrome admitted to Assiut University Children Hospital

Introduction
Hepatorenal syndrome (HRS) is defined as worsening kidney function in patients with advanced cirrhosis.
Aim
The study aimed to evaluate the management of children with HRS, who were admitted to the Pediatric Hepatology and Nephrology Units, Assiut University Children Hospital, according to published international guidelines, searching for defects, obstacles, or needs to improve the management of such cases.
Patients and methods
Medical records of children with advanced liver disease accompanied by renal manifestations during the period from the March 1, 2017 to the February 28, 2018 were collected and reviewed to choose the cases that fulfilled the inclusion criteria of the present study. A structured data collection form was designed according to the adopted published guidelines. The collected data were tabulated, statistically analyzed, and discussed.
Results
Out of 158 collected records, only 11 fulfilled the inclusion criteria of the present study. Their data revealed a severe defect in recording the admission and follow-up historical data, registered data about the clinical examination, important investigations, and management. Finally, the outcome data revealed that recovery with improvement of acute kidney injury had occurred in only two cases; they had early acute kidney injury diagnosis and proper management.
Conclusion
The study revealed that management of cases with HRS in the present study was not following any well-known published guidelines for management of such cases.
Recommendations
Management of children with HRS must follow the published international guidelines to improve both management and outcome of such cases.