Hepatorenal failure.
Since the description of HRS more than 100 years ago, significant advances have been made in understanding the pathophysiology of HRS and in the management of these patients. There is now a therapeutic armamentarium: medical (ornipressin plus plasma volume expansion), radiographic (TIPS shunt), and surgical (liver transplantation). The diagnosis of HRS is no longer synonymous with a death sentence; instead, it is a therapeutic challenge, and a coordinated approach by intensivists, hepatologists, nephrologists, interventional radiologists, and transplant surgeons is needed to continue to improve the prognosis of cirrhotic patients presenting with HRS. Increased understanding of HRS will allow preventative rather than therapeutic measures to be used. As in all fields of medicine, these advances will come only with innovative clinical investigation.
Division of Gastroenterology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
F
F
Wong
L
L
Blendis
D005260:Female; D006801:Humans; D017093:Liver Failure / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D008297:Male; D009102:Multiple Organ Failure / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D015995:Prevalence; D011379:Prognosis; D051437:Renal Insufficiency / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D012307:Risk Factors; D016019:Survival Analysis