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2013, Number 1

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AMC 2013; 17 (1)

Clinical Focus of the hepatorenal Syndrome

Arredondo BAE, Guerrero JG

Language: Spanish
References: 43
Page: 92-102
PDF size: 115.42 Kb.


ABSTRACT

Introduction: hepatorenal syndrome is a type of renal insufficiency that occurs in patients with cirrhosis of liver. It is the result of splanchnic arterial vasodilatation, renal vasoconstriction, reduction of the effective arterial volume, and potential reduction of the cardiac output. Development: hepatorenal syndrome is a fatal complication and the only definitive treatment currently available is the liver or liver-kidney transplant. Some other therapeutic treatment modalities have been conducted in the management of hepatorenal syndrome, but most of them are based on non-controlled studies and small samples. The primary role of these treatment options is to provide a door to liver transplant. Treatment may also lead to a regression to renal insufficiency or may produce some symptomatic relief, but relapse is the most frequent occurrence. The best therapeutic options seem to be those that revert to portal hypertension, splanchnic vasodilatation, and/or renal vasoconstriction. Conclusions: artificial support therapies have demonstrated the possibilities to improve laboratory abnormalities and the clinical picture of these patients, but their effect on clinical outcomes has not been determined. Renal replacement therapies or the new artificial support therapies need further evaluation before they can be routinely recommended.


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