Plasma cytokines levels (IL-6 and TNF-α) were higher in patients with RAI, although the difference was not statistically significant due to the high variation in cytokine levels. No significant differences were observed between groups regarding plasma levels of vasopressin and serum levels of nitric oxide. Table 3 shows serum total cortisol levels before and after the SST, transcortin, and albumin levels and serum cholesterol profile in patients with and without RAI. By definition delta cortisol and post-SST cortisol levels were significantly lower in patients with RAI. Baseline serum total cortisol levels,

serum levels of transcortin (the main cortisol binding protein), albumin, total cholesterol, and HDL were not significantly different between patients with normal and abnormal adrenal function. selleck inhibitor LDL levels tended to be lower in patients with RAI. Estimated baseline free cortisol levels (FCI and cFC) were also similar between groups. In 18 patients Proteases inhibitor (3 with and 15 without RAI) SST was repeated 153 ± 151 days after inclusion.

Two out of the three patients with RAI and 14 out of the 15 patients with normal adrenal function at admission showed normal delta values at follow-up. These data suggest that adrenal function in cirrhosis patients without RAI is relatively stable and that RAI is potentially reversible. Mean duration of hospitalization was 13 ± 12 days (from 2 to 83 days) with no significant differences between patients with and without RAI. Clinical outcome differed significantly between patients with

normal and abnormal adrenal function (Table 4). The probability of developing new bacterial infections (24% versus 9%; P = 0.01), new episodes of severe sepsis or septic shock (19% versus 4%, P = medchemexpress 0.008), and new type-1 HRS (11% versus 1%, P = 0.006) was significantly higher in patients with RAI than in those with normal adrenal function. The probability of death during hospitalization (16% versus 4%, P = 0.02) was also higher in patients with RAI. No new episodes of variceal bleeding occurred during hospitalization in either group. Mean follow-up was similar in patients with and without RAI (72 ± 30 versus 78 ± 25 days, respectively). Main outcomes at 3 months also differed between patients with normal and abnormal adrenal function (Table 4). The 3-month probability of developing new bacterial infections (41% versus 21%; P = 0.008), new severe sepsis, or septic shock episodes (27% versus 9%, P = 0.003, Fig. 1) and new type-1 HRS (16% versus 3%, P = 0.002) was higher in patients with RAI than in those with normal adrenal function. The probability of death was also significantly higher in patients with RAI (22% versus 7%, P = 0.01, Fig. 2).