Alcoholic cirrhosis-associated hepatorenal syndrome treated with vasoactive agents.
BACKGROUND
A 35-year-old man with alcoholic cirrhosis, ascites and alcoholic hepatitis presented with new-onset renal insufficiency of unclear etiology after recovery from an episode of gastrointestinal bleeding. Renal function continued to worsen after cessation of diuretic therapy and initiation of volume resuscitation.


METHODS
Physical examination, abdominal ultrasound, liver tests, basic metabolic panel, abdominal paracentesis, renal function tests, 24-h urine collections.


METHODS
Type 1 hepatorenal syndrome (HRS).


RESULTS
Intravascular volume resuscitation with normal saline and albumin followed by oral midodrine plus subcutaneous octreotide therapy. This regimen was continued until improvement and subsequent normalization of the serum creatinine.
Esrailian
Eric
E
Center for Health Sciences and the David Geffen School of Medicine at University of California, Los Angeles, CA, USA.
Runyon
Bruce A
BA
D058186:Acute Kidney Injury / Q000188:drug therapy* / Q000209:etiology*; D000328:Adult; D000418:Albumins / Q000627:therapeutic use; D006471:Gastrointestinal Hemorrhage / Q000150:complications; D006519:Hepatitis, Alcoholic / Q000150:complications; D006801:Humans; D007552:Isotonic Solutions / Q000627:therapeutic use; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications*; D008297:Male; D008879:Midodrine / Q000627:therapeutic use*; D012965:Sodium Chloride / Q000627:therapeutic use; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*
D000418:Albumins; D007552:Isotonic Solutions; D014662:Vasoconstrictor Agents; D012965:Sodium Chloride; D008879:Midodrine