Hepatorenal Syndrome Flashcards
(9 cards)
What is the ideal treatment for hepatorenal syndrome (HRS)?
Liver transplantation
Patients are often too unwell for surgery and there is a shortage of donors.
What causes the ‘underfilling’ of the kidneys in HRS?
Vasoactive mediators cause splanchnic vasodilation, reducing systemic vascular resistance.
What system is activated by the juxtaglomerular apparatus in response to underfilling of the kidneys?
Renin-angiotensin-aldosterone system
What is the hallmark of Type 1 HRS?
Doubling of serum creatinine to > 221 µmol/L or halving of creatinine clearance to < 20 ml/min over < 2 weeks.
What is the prognosis for Type 1 HRS?
Very poor prognosis
How does Type 2 HRS differ from Type 1 HRS?
Type 2 HRS is slowly progressive and prognosis is poor but patients may live longer.
What management option involves the use of vasoconstriction in HRS?
Vasopressin analogues, such as terlipressin.
What is the role of volume expansion with 20% albumin in HRS management?
It is a management option to improve renal function.
What is a transjugular intrahepatic portosystemic shunt used for?
It is a management option for hepatorenal syndrome.
