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Updated: Jul 20, 2026

Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy
Published on: June 18, 2020
Alcoholic cirrhosis-associated hepatorenal syndrome treated with vasoactive agents
Eric Esrailian1, Bruce A Runyon
1Center for Health Sciences and the David Geffen School of Medicine at University of California, Los Angeles, CA, USA.
Background:
A 35-year-old man with alcoholic cirrhosis, ascites and alcoholic hepatitis presented with new-onset renal insufficiency of unclear etiology after recovery from an episode of gastrointestinal bleeding. Renal function continued to worsen after cessation of diuretic therapy and initiation of volume resuscitation.
Investigations:
Physical examination, abdominal ultrasound, liver tests, basic metabolic panel, abdominal paracentesis, renal function tests, 24-h urine collections.
Diagnosis:
Type 1 hepatorenal syndrome (HRS).
Management:
Intravascular volume resuscitation with normal saline and albumin followed by oral midodrine plus subcutaneous octreotide therapy. This regimen was continued until improvement and subsequent normalization of the serum creatinine.
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