[Hepatorenal syndrome].
Hepatorenal syndrome (HRS) is a severe complication in patients with cirrhosis and ascites. Renal insufficiency is functional and is caused by renal vasoconstriction. HRS occurs in 10% of patients with advanced cirrhosis. Diagnosis of HRS is based on ruling out other causes of renal insufficiency. There are two types of HRS: type 1 has rapid onset and progressive course and a mean survival of 15 days without treatment, while type 2 is less severe and progressive, with a mean survival of 6 months. Definitive treatment of HRS is liver transplantation. However, in the last few years administration of vasoconstrictive drugs or placement of portosystemic shunts have been shown to be effective in reversing HRS. Therefore, these measures may be used as a bridge before liver transplantation is performed. Finally, the risk of developing HRS in the context of spontaneous bacterial peritonitis can be prevented by administering albumin together with the corresponding antibiotics. In cases of severe acute alcoholic hepatitis, pentoxifylline can be administered.
Baccaro
María E
ME
Servicio de Hepatología. Hospital Clínic. IDIBAPS. Barcelona. España.
Guevara
Mónica
M
D001201:Ascites / Q000209:etiology / Q000628:therapy; D003131:Combined Modality Therapy; D006530:Hepatorenal Syndrome / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control / Q000628:therapy; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D016031:Liver Transplantation; D011170:Portasystemic Shunt, Surgical; D011379:Prognosis; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000209:etiology / Q000628:therapy; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
D014662:Vasoconstrictor Agents