Interní Med. 2006; 8(3): 106-108

Hepatorenal syndrome

doc. MUDr. Radan Brůha CSc1, MUDr. Jaromír Petrtýl CSc1, doc. MUDr. Petr Urbánek CSc1, MUDr. Tomáš Švestka1, prof. MUDr. Zdeněk Mareček DrSc2
1 IV. interní klinika VFN a 1. LF UK, Praha
2 Interní klinika 1. LF UK a ÚVN Praha

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.

Keywords: Key words: cirrhosis, hepatorenal syndrome, portal hypertension.

Published: June 1, 2006  Show citation

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Brůha R, Petrtýl J, Urbánek P, Švestka T, Mareček Z. Hepatorenal syndrome. Interní Med. 2006;8(3):106-108.
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    References

    1. Angeli P, Volpin R, Gerunda G, Craighero R, Roner P, et al. Reversal of type 1 hepatorenal syndrome with the administration of midodrine and octreotide. Hepatology 1999; 29: 1690-1697. Go to original source... Go to PubMed...
    2. Akriviadis E, Botla R, Briggs W, Han S, Reynolds T, Shakil O. Pentoxyfylline improves short-term survival in severe acute alcoholic hepatitis: a double-blind, placebo-controlled trial. Gastroenterology 2000; 119: 1637-1648. Go to original source... Go to PubMed...
    3. Arroyo V, Gines P, Gerbes AL, Dudley FJ, Gentilini P, Laffi G, Reynolds TB, Larsen HR, Scholmerich J. Definition and diagnostic criteria of refractory ascites and hepatorenal syndrome in cirrhosis. Hepatology 1996; 23: 164-176. Go to original source... Go to PubMed...
    4. Brensing KA, Textor J, Perz J, et al. Long-term outcome after transjugular intrahepatic portosystemic stent-shunt in non-transplant patiens with hepatorenal syndrome: a phase II study. Gut 2000; 47: 288-295. Go to original source... Go to PubMed...
    5. Duvoux C, Zandirenas D, Hezode C, Chauvat A, Monin J et al. Effects of noadrenalin and albumin in patients with type 1 hepatorenal syndrome: a pilot study. Hepatology 2002; 36: 374-380. Go to original source... Go to PubMed...
    6. Gerbes AL, Gulberg V, Gines P, et al. Therapy of hyponatremia in cirrhosis with a vasopressin receptor antagonist: a randomized double-blind multicenter trial. Gastroenterology 2003; 124: 933-939. Go to original source... Go to PubMed...
    7. Gines A, Escorsell A, Ginas P, et al. Incidence, predictive factors, and prognosis of hepatorenal syndrome in cirrhosis with ascites. Gastroenterology 1993; 105: 229-236. Go to original source... Go to PubMed...
    8. Gines P, Guevara M, Arroyo V, Rodes C. Hepatorenal syndrome. Lancet 2003; 363: 1819-1827. Go to original source... Go to PubMed...
    9. Guevara M, Gines P, Bandi JC, et al. Transjugular intrahepatic portosystemic shunt in hepatorenal syndrome: effects on renal function and vasoactive systems. Hepatology 1998; 27: 35-41. Go to original source... Go to PubMed...
    10. Jarčuška P, Hildebrand T, Zakuciová M. Reverzibilita hepatorenálného syndrómu dlhotrvajúcim podáváním terlipressinu (Remestyp) v kombinácii s plazmaexpanziou. Popis 2 pripadov. Chirurgický zpravodaj 1999; 2: 39-44.
    11. Kamath PS, Wiesner RH, Malinchoc M, et al. A model to predict survival in patients with end-stage liver disease. Hepatology 2001; 33: 464-470. Go to original source... Go to PubMed...
    12. Lata J, Šenkyřík M. Hepatorenální syndrom. Interní medicína pro praxi 2002; 1: 6-9.
    13. Moller S, Henriksen JH. Pathogenesis and pathophysiology of hepatorenal syndrome - is there scope for prevention? Aliment Pharmacol Ther 2004; 20 (Suppl. 3): 31-41. Go to original source... Go to PubMed...
    14. Moore K, Wong F, Gines P, Bernardi M, Ochs A, et al. The management of ascites in cirrhosis: report on the consensus conference of the international ascites club. Hepatology 2003; 38: 258-266. Go to original source... Go to PubMed...
    15. Moreau R, Durand F, Poynard T, Duhamel C, Cervoni J-P, Ichai P, Abergel A, et al. Terlipressin in patients with cirrhosis and type I hepatorenal syndrome: a retrospective multicenter study. Gastroenteology 2002; 122: 923-930. Go to original source... Go to PubMed...
    16. Ortega R, Gines P, Uriz J, Cardenas A, Calahorra B, et al. Terlipressin therapy with and without albumin for patients with hepatorenal syndrom: results of a prospective nonrandomized study. Hepatology 2002; 36: 941-948. Go to original source... Go to PubMed...
    17. Pomier-Laylargues G, Paquin S, Hassoun Z, Lafortune M, Tran A: Octreotide in hepatorenal syndrome: a randomized, double blind, placebo controlled, crossover study. Hepatology 2003; 38: 238-243. Go to original source... Go to PubMed...
    18. Restuccia T, Ortega R, Guevara M, Gines P, Alessandria C, zdogan O, et al. Effects of treatment of hepatorenal syndrome before transplantation on posttransplantation outcome: A case-control study. J Hepatol 2004; 40: 140-146. Go to original source... Go to PubMed...
    19. Solanki P, Chawla A, Garg R, Gupta R, Jain M, Sarin S. Beneficial effects of terlipressin in hepatorenal syndrome: a prospective, randomized placebo-controlled clinical trial. J Gastroenterol Hepatol 2003; 18: 152-156. Go to original source... Go to PubMed...
    20. Sort P, Navasa M, Arroyo V, Aldeguer X, Planas R, Ruiz-del-Arbol L, et al. Effect of intravenous albumin on renal impairment and mortality in patients with cirrhosis and spontaneous bacterial peritonitis. N Engl J Med 1999; 341: 403-409. Go to original source... Go to PubMed...
    21. Uriz J, Gines P, Cardenas A, Sort P, Jimenez W, et al. Terlipressin plus albumin infusion: an affective ad safe therapy of hepatorenal syndrome. J Hepatol 2000; 33: 43-48. Go to original source... Go to PubMed...

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