Hepatorenal syndrome: pathophysiology, diagnosis, and management.

Abstract:

:Hepatorenal syndrome (HRS), the extreme manifestation of renal impairment in patients with cirrhosis, is characterized by reduction in renal blood flow and glomerular filtration rate. Hepatorenal syndrome is diagnosed when kidney function is reduced but evidence of intrinsic kidney disease, such as hematuria, proteinuria, or abnormal kidney ultrasonography, is absent. Unlike other causes of acute kidney injury (AKI), hepatorenal syndrome results from functional changes in the renal circulation and is potentially reversible with liver transplantation or vasoconstrictor drugs. Two forms of hepatorenal syndrome are recognized depending on the acuity and progression of kidney injury. The first represents an acute impairment of kidney function, HRS-AKI, whereas the second represents a more chronic kidney dysfunction, HRS-CKD (chronic kidney disease). In this review, we provide critical insight into the definition, pathophysiology, diagnosis, and management of hepatorenal syndrome.

journal_name

BMJ

authors

Simonetto DA,Gines P,Kamath PS

doi

10.1136/bmj.m2687

subject

Has Abstract

pub_date

2020-09-14 00:00:00

pages

m2687

eissn

0959-8138

issn

1756-1833

journal_volume

370

pub_type

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