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[Hepatorenal syndrome]
Srpski Arhiv Za Celokupno Lekarstvo
|May 17, 2007
Summary
Hepatorenal syndrome (HRS) is a severe kidney complication in advanced cirrhosis, characterized by functional renal failure. Early prevention and vasoconstrictor therapies can improve outcomes, with liver transplantation as the only cure.
Area of Science:
- Nephrology
- Hepatology
- Gastroenterology
Context:
- Advanced cirrhosis leads to hepatorenal syndrome (HRS), a serious complication.
- HRS involves functional renal failure due to splanchnic vasodilatation and reduced arterial blood volume.
- This triggers compensatory vasoconstriction, worsening renal ischemia and glomerular filtration rate (GFR).
Purpose:
- To define hepatorenal syndrome (HRS) and its underlying pathophysiology in advanced cirrhosis.
- To outline the diagnostic criteria and precipitating factors for HRS.
- To discuss the prognosis and current therapeutic strategies for HRS.
Summary:
- Hepatorenal syndrome (HRS) is characterized by functional renal failure and altered blood pressure in advanced cirrhosis.
- Pathogenesis involves splanchnic vasodilatation, reduced effective arterial volume, and activation of vasoconstrictor systems.
- Two types exist: Type I (rapidly progressive) and Type II (slower, with refractory ascites).
Impact:
- HRS has a very poor prognosis, with liver transplantation being the only definitive cure.
- Vasoconstrictor pharmacotherapies can serve as a bridge to liver transplantation.
- Prevention strategies include albumin infusion for spontaneous bacterial peritonitis and pentoxifylline for alcoholic hepatitis.
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