Hepato-renal syndrome

Hepato-renal syndrome

    * Introduction
    * Pathogenesis
    * Causes and Risk Factors
    * Signs and symptoms
    * Diagnosis
    * Treatment
Hepato-renal syndrome defines installation, apparently without any specific cause of a kidney failure, progressive, functional, theoretically reversible in a patient with severe liver failure. The probability that a cirrhotic patient to develop hepato-renal syndrome is 18% at 1 year and 39% at 5 years after diagnosis of liver disease.
Chronic kidney patient suffering liver function in the context of cortical ischemia caused by unknown stimuli that cause vasoconstriction, preferentially in the renal cortex. The more pain the more severe liver, renal ischemia background is more advanced, the kidney is highly susceptible to further attacks (hemodynamic instability, paracentesis, high-dose diuretic therapy, gastrointestinal bleeding, nephrotoxic medications, sepsis).
Hepato-renal syndrome occurs in patients with cirrhosis of alcoholic etiology frequently already shows all the complications of severe disease (chronic ascites requiring diuretic therapy, gastrointestinal bleeding and eventually hepatic encephalopathy). Associated risk factors are malnutrition, low liver, esophageal varices, infection, gastrointestinal bleeding, diuretic therapy or paracentesis.
Most people experience symptoms nonspecific fatigue, malaise, caofuzie, marked asthenia. Development of hepato-renal syndrome is suspected when blood tests show appears oliguria and impaired renal function. Prevention of hepato-renal syndrome may be maintaining the patient's fluid and electrolyte balance, diuretic therapy be closely monitored, avoiding nephrotoxic substances and early recognition of digestive bleeding and spontaneous bacterial peritonitis.
The prognosis remains infaust hepato-renal syndrome, almost all patients who died without a liver transplant.