Treatment of hepatorenal syndrome

Five patients with hepatorenal syndrome were treated with a LeVeen peritoneovenous shunt and furosemide. Four of the five patients responded immediately with urinary volumes in excess of 2 liters on the day of surgery and the subsequent 3 postoperative days. Urinary sodium excretion increased from 5 to 122 mEq/liter after insertion of a peritoneovenous shunt. Body weight decreased by 7.7 kg in 1 week. Serum creatinine decreased from 4.0 to 1.8 mg/dl in 1 week. There were two long-term survivors. Peritoneovenous shunting is an effective method of reversing the renal component in the hepatorenal syndrome.