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[Disorders of kidney function in hepatic coma]

H Lochs, G Kleinberger, W Druml

    Leber, Magen, Darm
    |October 1, 1982
    PubMed
    Summary
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    This study investigated renal function in 80 hepatic coma patients, finding significant renal impairment. Prophylactic dopamine and fluid/electrolyte replacement are suggested for managing hepatic coma-related kidney issues.

    Area of Science:

    • Nephrology
    • Hepatology
    • Critical Care Medicine

    Context:

    • Hepatic coma, a severe complication of liver disease, significantly impacts multiple organ systems.
    • Renal dysfunction is a common and serious comorbidity in patients with advanced hepatic failure.
    • Understanding the patterns of renal impairment is crucial for effective patient management.

    Purpose:

    • To evaluate renal function in patients with hepatic coma (stages III-IV).
    • To identify specific renal abnormalities, including reduced creatinine clearance and hyperaldosteronism.
    • To assess the prevalence of overt renal failure across different forms of hepatic coma.

    Summary:

    • Eighty patients with hepatic coma (acute fulminant, chronic, or mixed forms) underwent renal function assessment.

    Related Experiment Videos

  • Measurements included plasma/urine urea, creatinine, electrolytes, creatinine clearance, and urine sodium/potassium ratio.
  • Renal failure was defined as serum creatinine > 3 mg/dl; abnormalities like reduced clearance, hyperaldosteronism, and tubular necrosis were noted across patient groups.
  • Impact:

    • Findings highlight the high incidence of renal dysfunction in hepatic coma, varying by etiology.
    • The study suggests prophylactic use of dopamine and intravenous sodium/water for managing renal complications.
    • This research informs clinical practice regarding the monitoring and treatment of kidney function in liver failure patients.