Assessment and comparative analysis of renal function parameters in patients with liver cirrhosis and atrial fibrillation

Abstract

Background. Currently, there is insufficient scientific data on renal function in patients with comorbid course of liver cirrhosis (LC) and atrial fibrillation (AF), as well as the effect of anticoagulant treatment on kidney function in these patients. The aim of the study is assessment and comparison of renal function parameters in patients with liver cirrhosis and atrial fibrillation before and after warfarin and dabigatran treatment during three months. Materials and methods. A randomized clinical trial with a 2-stage design was conducted. At the I stage, 106 patients took part in the study: 70 of them with a comorbid course of LC and AF, 36 with LC alone. At the II stage, 56 people with LC and AF received warfarin and dabigatran for three months. A comparative assessment of creatinine, blood urea nitrogen (BUN), glomerular filtration rate (GFR) before and after treatment was carried out. Results and discussion. In patients with LC and AF, renal dysfunction is more severe due to deterioration of creatinine, BUN and GFR compared to those with LC alone (p < 0.05). Warfarin treatment of patients with LC and AF is characterized by a statistically significant worsening of creatinine, BUN and GFR (р < 0.05). On the other hand, in the group of patients with LC and AF treated with dabigatran, these paraments do not differ significantly from the baseline values (р > 0.05). Conclusions. Patients with the comorbid pathology of LC and AF have statistically worse renal function parameters compared to individuals with LC alone. After treatment of patients with LC and AF with anticoagulant drugs for three months, functional kidney parameters significantly worsened compared to those before treatment. Warfarin treatment of patients with LC and AF is characterized by a statistically significant worsening of creatinine, BUN and GFR compared to dabigatran-treated patients.