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Prognostic Significance of Relative Adrenal Insufficiency (RAI) in a Patient with Liver Disease

Description

Jang et al evaluated the prognostic significance of relative adrenal insufficiency (RAI) in a patient with chronic liver disease. This can help to identify a patient who may benefit from more aggressive management. The authors are from Soonchunhyang University and Hanyang University Guri Hospital in Korea.


 

Patient selection: chronic liver disease including cirrhosis

 

Criteria for relative adrenal insufficiency:

(1) basal (baseline) total serum cortisol < 36 micrograms per dL

(2) increase in serum cortisol < 9 micrograms per dL following a dose of 250 micrograms corticotrophin (short stimulation test)

 

Relative adrenal insufficiency is associated with:

(1) more advanced liver disease

(2) lower long-term survival

 

Cirrhosis

1-Year Survival

3-Year Survival

RAI absent

95%

95%

RAI present

69%

0%

 


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