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[Hepatorenal syndrome].

P Pŭrvanov

    Khirurgiia
    |January 8, 2003
    PubMed
    Summary
    This summary is machine-generated.

    Hepatorenale Syndrom (HRS) ist eine Nierenfunktionsstörung bei Leberversagen, gekennzeichnet durch Nierenversagen ohne andere Nierenpathologien. Die Prävention auslösender Faktoren ist die beste Behandlung für HRS, da die Prognose ohne Lebertransplantation schlecht ist.

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    Area of Science:

    • Nephrology
    • Hepatology
    • Gastroenterology

    Context:

    • Functional renal disorders are common in cirrhosis and ascites.
    • Hepatorenal syndrome (HRS) represents the terminal stage of renal complications in advanced liver disease.
    • Renal impairment affects over 30% of cirrhosis patients, with HRS occurring in about 5%.

    Purpose:

    • To define Hepatorenal Syndrome (HRS) and its diagnostic criteria.
    • To review the pathophysiology of HRS, including circulatory instability and activation of vasoactive systems.
    • To explore various therapeutic approaches for HRS and discuss their efficacy.

    Summary:

    • HRS is characterized by renal failure in patients with advanced liver failure, without other identifiable renal pathology.
    • Diagnostic criteria include serum creatinine > 1.5 mg/dl and creatinine clearance < 40 ml/min, as defined by the International Ascites Club.

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  • Therapeutic strategies aim to improve systemic and renal hemodynamics, including plasma expanders, vasoconstrictors, and shunts.

    • Impact:

    • HRS has a poor prognosis, with liver transplantation being the only definitive treatment.
    • Preventing precipitating factors is crucial for managing HRS.
    • Understanding HRS pathophysiology and diagnostic criteria aids in timely intervention and management.