General

Hepatorenal syndrome

Created by:

 
29 Aug 2016 - General
 

Hepatorenal syndrome occurs in patient with advanced liver failure and portal hypertension. There are 2 type of hepatorenal syndrome. Type 1 hepatorenal syndrome is characterized by rapid and progressive reduction of renal function by a doubling of the initial creatinine to a level of greater then 2.5mg/dL or a 50% reduction in the iniital 24 hour creatinine clearance to a levl of less than 20mL/min in less than 2 weeks. Type 2 hepatorenal syndrome does not have such rapid progressive course, but do develop clinical picture of refractory ascites. The dianosis criteria of hepatorenal syndrome was defined by International Ascites Club. The treatment of choice for hepatorenal syndrome will be liver transplantation.

You Yi Hong "Endogenous vasoconstriction due to arterial vasodilatation in the splanchnic circulation and severe reflex activation of the endogenous vasoconstrictive systems." Well to be honest this bit is slightly confusing to me. What kind of a relationship is there between vasodilatation in the splanchnic circulation endogenous vasoconstriction in the renal vascular bed? And how can infusion of album...
 (Total 110 words)
Hepatorenal syndrome is developed in patients with advanced liver disease which is characterized by portal hypertension and ascites. In hepatorenal syndrome renal vasoconstriction takes place with reduced peripheral resistance. Though the ultimate result of the pathogenesis is well known, the mechanism of the pathogenesis is not fully described. In the patients with cirrhosis and ascites, renin-angiotensin-aldosterone mechanism and the activity of the sympathetic nervous system usually become p...
 (Total 102 words)
Yes, Theekshana Abayawickrama those patients with advanced liver cirrhosis who developed hepatorenal syndrome will be extremely sick and have a very poor prognosis. The mortality of untreated patient with type 1 hepatorenal syndrome is almost 100% !!!The proposed pathophysiology behind this condition is that it is a functional renal failure caused by the endogenous vasoconstriction due to arterial vasodilatation i...
 (Total 106 words)
I have seen several cases of hepatorenal syndrom during the time I worked in an adult medicine ward. Most of the times, patients who develop hepatorenal syndrome are terminally ill patients with advanced or end stage liver cell disease. Failing of one organ alone is too much for the body to handle, two organs failing at the same time makes things much worse so there is not much that we can do to these patients to end their misery. The pathophysiology behind hepatorenal syndrome is also still poo...
 (Total 108 words)