title: New insights into the management of hepato-renal syndrome.
abstract: Hepato-renal syndrome (HRS) is a serious complication in patients with advanced liver disease indicating a very poor prognosis. Nevertheless, effective treatment strategies have been introduced into clinical practice over the last decade. The combined treatment with terlipressin/albumin has been proven to be effective in most published studies and should be regarded as the standard of care. Norepinephrine or midodrine are possible alternatives when terlipressin is not available. Although there is presently not enough evidence to recommend extracorporeal liver support therapy as a standard procedure in patients with HRS, these concepts constitute promising options that need to be studied in prospective clinical trials.
authors.affiliation: Department of Nephrology and Medical Intensive Care, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany.
authors.forename: Dietrich
authors.initials: D
authors.lastname: Hasper
authors.forename: Achim
authors.initials: A
authors.lastname: Jörres
mesh_terms: D019468:Disease Management; D006530:Hepatorenal Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D008236:Lypressin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008879:Midodrine / Q000627:therapeutic use; D009638:Norepinephrine / Q000627:therapeutic use; D006435:Renal Dialysis / Q000379:methods; D000077585:Terlipressin
chemical_list: D008236:Lypressin; D008879:Midodrine; D000077585:Terlipressin; D009638:Norepinephrine