Diagnostics and therapy of hepatorenal syndrome. Recommendations of of the working group on portal hypertension of the Czech Hepatology Society and the J. E. Purkinje Czech Medical Society
Brůha, R.; Skupiny, Cé.; Balihar, K.; Drastich, P.; Hůlek, P.; Lata, J.; Petrtýl, J.; Procházka, V.; Spicák, J.; Vanásek, T.; Volfová, M.; Zdenek, P.
Vnitrni lekarstvi 52(6): 649-650
2006
ISSN/ISBN: 0042-773X PMID: 16871772 Document Number: 596993
Hepatorenal syndrome is a functional renal failure in patients with advanced cirrhosis and portal hypertension or acute liver failure. It is caused by extreme vasoconstriction in renal arterial bed. Type I HRS presents as an acute renal failure, while type II HRS is chronic alteration of renal function in patients with refractory ascites. Prognosis of HRS is very poor with survival reaching several weeks in patients with HRS type I. Causal treatment is liver transplantation, other treatment options include use of splanchnic vasoconstrictors (terlipressin) together with plasmaexpansion (albumin) and TIPS. It is important to exclude nephrotoxic medication (non-steroid anti inflammatory drugs, aminoglycosides) and properly treat all infective complications in prevention of HRS.