Hepatorenal Syndrome

  • Abdussalam Shredi Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX
  • Sakolwan Suchartlikitwong Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX
  • Hawa Edriss Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX
Keywords: hepatorenal syndrome, liver cirrhosis, portal hypertension, splanchnic vasodilatation, nitric oxide, hepatorenal reflex

Abstract

Hepatorenal syndrome is a form of acute kidney injury that occurs in chronic liver disease
and acute fulminant liver failure. This syndrome features a rapid progressive decline in renal
function in the absence of other obvious causes of renal dysfunction. The pathophysiology
of this syndrome is still not completely understood, and several mechanisms have been
proposed to explain its pathogenesis. The characteristic feature of hepatorenal syndrome is
intense renal vasoconstriction. The local production of vasodilator substances as a result of
portal hypertension have a central role in the pathogenesis of the hepatorenal syndrome as
they lead to splanchnic pooling and decreased effective systemic arterial plasma volume and
renal vasoconstriction. Hepatorenal syndrome is a diagnosis of exclusion and is considered a
challenging medical condition in both diagnosis and treatment as it is associated with a poor
prognosis. This article will review the two main hypotheses about the pathogenesis, diagnostic
criteria, and treatment approaches to the hepatorenal syndrome.

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Published
2018-01-19
How to Cite
Shredi, A., Suchartlikitwong, S., & Edriss, H. (2018). Hepatorenal Syndrome. The Southwest Respiratory and Critical Care Chronicles, 6(22), 21-28. https://doi.org/10.12746/swrccc.v6i22.439