title: Hepatorenal syndrome in cirrhosis: diagnostic, pathophysiological, and therapeutic aspects.
abstract: Renal failure is a common and serious complication in cirrhosis and represents a wide spectrum of etiologies. The hepatorenal syndrome (HRS) represents a distinct type of renal failure, only seen in cirrhotic patients with ascites. The diagnostic criteria, knowledge in the pathophysiology of renal failure and HRS, and treatment hereof, have evolved tremendously during the last decades, and it is the aim of this review to summarize these discoveries. Areas covered: The focus will primarily be on treatment and prevention of renal failure and HRS, but areas concerning definition, diagnosis, including biomarkers, and pathophysiology, will also be covered through a comprehensive, critical reading of the latest literature, encompassing the most recent, updated, international guidelines, reviews and high-impact original literature. Expert commentary: The advances made in the understanding of the pathophysiology of HRS and other complications of cirrhosis within the recent decades, have provided the basis for improved diagnostic criteria and the development of treatments that have substantially increased survival rates in cirrhotic patients suffering from these conditions. Focus should, in the nearest future, be on continuing this positive development, thus further improving prognosis for cirrhotic patients with HRS.
authors.affiliation: a Department of Clinical Physiology and Nuclear Medicine , Centre of Functional Imaging and Research, Copenhagen University Hospital Hvidovre , Hvidovre , Denmark.|b Gastro Unit, Medical Division , Copenhagen University Hospital Hvidovre , Hvidovre , Denmark.
authors.forename: Troels M
authors.initials: TM
authors.lastname: Busk
authors.affiliation: b Gastro Unit, Medical Division , Copenhagen University Hospital Hvidovre , Hvidovre , Denmark.
authors.forename: Flemming
authors.initials: F
authors.lastname: Bendtsen
authors.affiliation: a Department of Clinical Physiology and Nuclear Medicine , Centre of Functional Imaging and Research, Copenhagen University Hospital Hvidovre , Hvidovre , Denmark.
authors.forename: Søren
authors.initials: S
authors.lastname: Møller
keywords: Renal failure; cirrhotic cardiomyopathy; hepatorenal syndrome; human albumin; liver transplantation; peripheral arterial vasodilation hypothesis; portal hypertension; preventive care; systemic inflammation hypothesis; vasoconstrictors