Prevalence and Determinants of Hepatorenal Syndrome among Adults with Decompensated Advanced Chronic Liver Disease admitted at Muhimbili National Hospital, Dar Es Salaam, Tanzania

Background Hepatorenal syndrome (HRS) is a severe complication of Decompensated Advanced Chronic Liver Disease (dACLD) with more than 80% mortality when not well treated. There is no published Tanzanian evidence on its prevalence and determinants. Therefore, this study aimed to assess the prevalence and determinants of hepatorenal syndrome among adults with dACLD admitted at Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania. Methods We conducted a hospital‑based cross-sectional study over six months (August 2024 to January 2025) among 100 consecutively enrolled adults with dACLD at MNH. Data on sociodemographic, clinical, and laboratory characteristics were collected. HRS was diagnosed using International Ascites Club (2015/2021) criteria. Stata 15 was used to analyze the data, and multivariable Poisson regression with robust standard errors was used to assess the determinants of HRS, where variables with a bivariable p-value ≤ 0.2 at 95% Confidence Interval (CI) were taken to multivariable, and the significance was measured at the p-value ≤ 0.05 at 95% CI. Results The prevalence of HRS was 11.0% (95% CI 5.0–18.0). The determinants of HRS were hyponatremia (serum sodium < 125 mmol/L) and hypoalbuminemia (serum albumin < 2.5 g/dL), which were independently associated with HRS (aPR 3.95, 95% CI 1.36–11.51; and aPR 4.94, 95% CI 1.20–20.28, respectively). However, other clinical factors, including upper gastrointestinal bleeding and higher Model for End-Stage Liver Disease (MELD) category, showed positive association but were not statistically significant. Conclusion The prevalence of HRS among dACLD patients at MNH was 11.0%, whereby hyponatremia and hypoalbuminemia were the key determinants. This underscores the need for routine monitoring of sodium and albumin to flag high‑risk patients, and timely access to supportive therapies should be prioritized.