Interní Med. 2013; 15(8-9): 253-255

Hepatorenal syndrome

prof.MUDr.Jan Lata, CSc.

Interní klinika Lékařské fakulty Ostravské univerzity v Ostravě a FN Ostrava

Hepatorenal syndrome (HRS) is defined as a functional renal failure in patients with liver disease with portal hypertension and it constitutes the

climax of systemic circulatory changes associated with portal hypertension. This term refers to a precisely specified syndrome featuring in

particular morphologically intact kidneys. The syndrome occurs almost exclusively in patients with ascites. Liver transplantation is the most

appropriate therapeutic method, nevertheless, only few patients can receive it. The most suitable „bridge treatments“ or treatment for patients

ineligible for a liver transplant include terlipressin plus albumin. Terlipressin is commonly used by intravenous boluses moving from an initial

dose of 0.5–1 mg every 4 h to 3 mg every 4 h in cases when there was no response. Renal function recovery can be achieved in less than 50 % of

patients and a considerable decrease in renal function may reoccur even in patients who have been responding to the therapy over the short term.

Keywords: liver cirrhosis, hepatorenal syndrome, ascites, vasoconstrictors, terlipressin, albumin

Published: October 1, 2013  Show citation