[The hepatorenal syndrome]

The hepatorenal syndrome is a renal failure in patients with decompensated cirrhosis. It is characterized by the absence of histological lesions of the kidneys and a poor prognosis. The functional renal failure is due to active cortical vasoconstriction, the mechanism of which is unknown. Blockade of prostaglandins, which are vasoactive substances necessary to maintain a normal renal blood flow, results in a transient hepatorenal syndrome in cirrhotic patients with ascites. Leukotriens, which are vasoconstrictive substances, might play a major causative role. There is, as yet, no specific treatment.