title: [Disorders of kidney function in hepatic coma].
abstract: Renal function was evaluated in 80 patients with hepatic coma stage III-IV (24 patients had acute fulminant hepatic failure, 48 patients chronic hepatic failure, 8 patients had a mixed form). Urea, creatinine and electrolytes were measured in plasma and urine as well as creatinine clearance and sodium/potassium ratio in urine. Renal failure was defined as an increase of serum creatinine above 3 mg/dl. In 15 of the 24 patients with fulminant hepatic failure creatinine clearance was reduced; hyperaldosteronism was present in 13 cases; in 2 patients there was necrosis of the tubulus, in 9 patients overt renal failure. In patients with chronic hepatic failure creatinine clearance was pathological in 36 cases, hyperaldosteronism was diagnosed in 23 cases and necrosis of renal tubules in 3 cases; 8 patients had overt renal failure. In the group with the mixed form of hepatic coma creatinine clearance was pathological in 3 cases, in 6 cases hyperaldosteronism was diagnosed; necrosis of the tubules could not be found in this group; 4 patients had overt renal failure. It is suggested that for treatment of this condition dopamine should be given prophylactically as well as intravenous sodium and water substitution.
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood*; D000328:Adult; D003404:Creatinine / Q000097:blood; D005260:Female; D006501:Hepatic Encephalopathy / Q000097:blood / Q000150:complications*; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood; D007677:Kidney Function Tests; D007683:Kidney Tubular Necrosis, Acute / Q000097:blood; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000097:blood; D012964:Sodium / Q000097:blood; D014508:Urea / Q000097:blood
chemical_list: D014508:Urea; D012964:Sodium; D003404:Creatinine; D011188:Potassium
vernacular_title: Störungen der Nierenfunktion bei Coma hepaticum.