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To determine outcome and mortality risk related to acute renal failure (ARF) in critically ill patients with cirrhosis.

A retrospective cohort analysis and two independent case-control analyses in a medical ICU.

41 and 32 patients who developed mild and severe ARF, respectively, matched (1:2 ratio) with cirrhotic patients without ARF during their ICU stay.

Cirrhotic patients with ARF had higher MELD, APACHE II, and SOFA scores at baseline that those without ARF. They had more respiratory failure and cardiovascular failure during ICU stay, longer stay in ICU, and a greater crude hospital mortality rate (65% vs. 32%). Multivariate survival analysis identified ARF (hazard ratio, HR, 4.1), alcohol abuse or dependency, and …