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Nephrotic Syndrome I : Introduction01:24

Nephrotic Syndrome I : Introduction

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Nephrotic Syndrome is a chronic kidney disorder defined by clinical findings such as severe proteinuria, hypoalbuminemia, hyperlipidemia, and edema. These symptoms result from damage to the glomeruli, the kidney’s filtering units, increasing their permeability to proteins.Definition and Meaning:Proteinuria, defined as the loss of more than 3.5 grams of protein per day in adults, is a crucial feature of nephrotic syndrome. This condition is often accompanied by edema, the accumulation of...
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Acute Coronary Syndrome I: Introduction01:30

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Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
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Irritable Bowel Syndrome I: Introduction01:17

Irritable Bowel Syndrome I: Introduction

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Irritable Bowel Syndrome (IBS) is characterized by functional disturbances in the gastrointestinal system, presenting a cluster of symptoms without evident structural or biochemical abnormalities. It primarily affects the large intestine and may cause abdominal pain, bloating, excessive gas, diarrhea, constipation, or both.
IBS is a chronic condition that can persist over a long period or recur frequently.
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Altered...
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Restless Leg Syndrome and Night Terrors01:27

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Restless Leg Syndrome (RLS), also known as Willis-Ekbom disease, is a neurological disorder characterized by an uncontrollable urge to move the legs due to uncomfortable sensations. These sensations typically occur during periods of rest or inactivity, particularly when lying down or sitting, and can severely disrupt sleep.
The exact cause of RLS is not fully understood, but it is believed to involve dopamine, a neurotransmitter that helps regulate muscle movement. Imbalances in dopamine levels...
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Acute Coronary Syndrome V: Nursing Management01:26

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Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...
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Nephrotic Syndrome II : Assessment and Medical Management01:26

Nephrotic Syndrome II : Assessment and Medical Management

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IntroductionNephrotic syndrome is a kidney disorder marked by excessive protein loss in the urine, leading to various systemic complications. This condition often results from damage to the glomeruli—the kidney's filtering units—causing proteinuria, low blood protein levels, and fluid retention. Understanding the assessment, diagnosis, and management of nephrotic syndrome is essential for effective treatment and prevention of further kidney damage.AssessmentPatient History: Document...
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Conscious and Non-conscious Representations of Emotional Faces in Asperger's Syndrome
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[Hepatorenal syndrome : something new?]

Hannah Wozniak1, Patrick Saudan2, Pierre-Yves Martin2

  • 1Service de médecine interne générale, HUG, 1211 Genève 14.

Revue Medicale Suisse
|February 21, 2019
PubMed
Summary

Hepatorenal syndrome, a severe kidney complication in liver cirrhosis patients, involves rapid kidney injury. Treatment includes albumin, vasoconstrictors, and potentially liver transplantation.

Area of Science:

  • Nephrology
  • Hepatology
  • Critical Care Medicine

Background:

  • Hepatorenal syndrome (HRS) is a frequent and severe complication in patients with liver cirrhosis.
  • It presents as a functional acute kidney injury, primarily diagnosed by exclusion.
  • The underlying pathophysiology involves splanchnic vasodilation, leading to systemic and renal vasoconstriction, fluid retention, and cardiac dysfunction.

Purpose of the Study:

  • To summarize the current understanding of hepatorenal syndrome (HRS) in liver cirrhosis.
  • To outline diagnostic considerations and recommended management strategies.
  • To emphasize the importance of a multidisciplinary approach for patients with HRS.

Main Methods:

  • Literature review of hepatorenal syndrome pathophysiology, diagnosis, and treatment.

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  • Analysis of current clinical guidelines and expert recommendations.
  • Discussion of management options including medical therapy and liver transplantation.

    • Main Results:

    • Hepatorenal syndrome is characterized by functional acute kidney injury in liver cirrhosis.
    • Current management recommendations include intravenous albumin combined with vasoconstrictors (terlipressin or noradrenaline).
    • Liver transplantation is a crucial consideration due to the high mortality associated with HRS.

    Conclusions:

    • Hepatorenal syndrome is a critical complication of liver cirrhosis requiring prompt recognition and management.
    • Effective treatment involves a combination of albumin and vasoconstrictors, with liver transplantation as a definitive option.
    • A multidisciplinary team approach is essential for managing the renal and potential multiorganic failure in HRS patients.