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Hepatorenal syndrome.
Trop Gastroenterol. 2002 Jul-Sep; 23(3):113-6.TG

Abstract

Hepatorenal syndrome is a life-threatening complication occurring commonly in cirrhosis liver and rarely in acute liver failure. It can be precipitated by shock, infection, surgery, large volume paracentesis or nephrotoxic drugs. Type I hepatorenal syndrome which usually develops over acute liver failure is rapidly progressive and has poor outcome. Type II hepatorenal syndrome is usually associated with refractory ascites and is slowly progressive with relatively good prognosis. Peripheral vasodilation with intrarenal vasoconstriction is the main pathophysiologic change. Diagnostic criteria, ascertained by international ascites club, is helpful to reach at a proper diagnosis. Management includes pharmacologic therapy to induce splanchnic vasoconstriction which improve renal circulation. Dopamine, vasopressin analogs (ornipressin and terlipressin), midodrine, noradrenaline have been used mainly as a bridge to the liver transplant or in anticipation of improvement in hepatic function. The molecular adsorbent recycling system (MARS) have been recently used in patients with hepatorenal syndrome. Transjugular intrahepatic portosystemic shunt is also another modality which has been used as a bridge to liver transplant in such patients.

Authors+Show Affiliations

Biswas KD
Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221 005.
Jain AK
No affiliation info available

MeSH

AscitesHepatorenal SyndromeHumansHypertension, PortalLiver CirrhosisLiver TransplantationPortasystemic Shunt, Transjugular IntrahepaticPrognosisRenal CirculationRenal Replacement TherapySplanchnic CirculationVasoconstrictionVasoconstrictor AgentsVasodilationVasodilator Agents

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

12693150

Citation

Biswas, K D., and A K. Jain. "Hepatorenal Syndrome." Tropical Gastroenterology : Official Journal of the Digestive Diseases Foundation, vol. 23, no. 3, 2002, pp. 113-6.
Biswas KD, Jain AK. Hepatorenal syndrome. Trop Gastroenterol. 2002;23(3):113-6.
Biswas, K. D., & Jain, A. K. (2002). Hepatorenal syndrome. Tropical Gastroenterology : Official Journal of the Digestive Diseases Foundation, 23(3), 113-6.
Biswas KD, Jain AK. Hepatorenal Syndrome. Trop Gastroenterol. 2002 Jul-Sep;23(3):113-6. PubMed PMID: 12693150.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hepatorenal syndrome. AU - Biswas,K D, AU - Jain,A K, PY - 2003/4/16/pubmed PY - 2003/5/21/medline PY - 2003/4/16/entrez SP - 113 EP - 6 JF - Tropical gastroenterology : official journal of the Digestive Diseases Foundation JO - Trop Gastroenterol VL - 23 IS - 3 N2 - Hepatorenal syndrome is a life-threatening complication occurring commonly in cirrhosis liver and rarely in acute liver failure. It can be precipitated by shock, infection, surgery, large volume paracentesis or nephrotoxic drugs. Type I hepatorenal syndrome which usually develops over acute liver failure is rapidly progressive and has poor outcome. Type II hepatorenal syndrome is usually associated with refractory ascites and is slowly progressive with relatively good prognosis. Peripheral vasodilation with intrarenal vasoconstriction is the main pathophysiologic change. Diagnostic criteria, ascertained by international ascites club, is helpful to reach at a proper diagnosis. Management includes pharmacologic therapy to induce splanchnic vasoconstriction which improve renal circulation. Dopamine, vasopressin analogs (ornipressin and terlipressin), midodrine, noradrenaline have been used mainly as a bridge to the liver transplant or in anticipation of improvement in hepatic function. The molecular adsorbent recycling system (MARS) have been recently used in patients with hepatorenal syndrome. Transjugular intrahepatic portosystemic shunt is also another modality which has been used as a bridge to liver transplant in such patients. SN - 0250-636X UR - https://www.unboundmedicine.com/medline/citation/12693150/Hepatorenal_syndrome_ DB - PRIME DP - Unbound Medicine ER -