The Hepatorenal Syndrome-A Review

Prabhu, Mayoor V. and *, Sukanya B and Pai, Santosh B.H. and Reddy, Sreedhar (2014) The Hepatorenal Syndrome-A Review. in Italian Journal of Nephrology , 31 (3). pp. 1-18. ISSN 1724-5590

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Abstract

The Hepato Renal Syndrome (HRS) remains a diagnostic and therapeutic conundrum. Controversies persist in the definition, understanding of pathophysiological mechanisms, diagnosis, and therapy of renal dysfunction complicating End Stage Liver Disease (ESLD).While ESLD is complicated by dysfunction in multiple organs, renal disease holds particular bearing on long term outcomes. Liver transplantation is the therapy of choice for ESLD-and co existing renal dysfunction makes it more difficult and challenging. Given that a bare minimum of patients with ESLD will ultimately receive a liver transplant, especially in the developing world, renal dysfunction may ultimately portend untimely death in a many of these patients. It is also critical to recognize the fact that HRS is not the sole cause of renal failure in ESLD. Hence, early recognition and therapy may prolong life even in those who will not receive a transplant for multitude of reasons. Renal Replacement Therapy (RRT) is also a challenge in this patient population, leading to issues with hemodynamics, vascular access and anticoagulation. We take a look at recent literature and advances in the understanding of the pathophysiology of this particularly difficult condition, and its diagnosis and management.

Item Type: Article
Uncontrolled Keywords: acute kidney injury, End Stage Liver Disease, Liver transplantation, Renal dysfunction in liver disease, Renal Replacement Therapy
Subjects: Medicine > KMC Mangalore > Surgery
Depositing User: KMCMLR User
Date Deposited: 31 Oct 2014 06:47
Last Modified: 25 Nov 2014 09:51
URI: http://eprints.manipal.edu/id/eprint/140952

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