Hepatorenal Syndrome

Posted by e-Medical PPT Monday, September 6, 2010
Hepatorenal syndrome is a life-threatening medical condition that consists of rapid deterioration in kidney function in individuals with cirrhosis or acute liver failure.Spontaneous bacterial peritonitis, which is the infection of ascites fluid, is the most common precipitant of HRS in cirrhotic individuals.HRS is usually fatal unless a liver transplant is performed and dialysis, can prevent advancement of the condition.Two forms of hepatorenal syndrome have been defined: In Type 1 HRS there is a rapidly progressive decline in kidney function, while type 2 HRS is associated with ascites that does not improve with standard diuretic medications.
Both types of hepatorenal syndrome share three major components: altered liver function, abnormalities in circulation, and renal failure.Most people who develop HRS have cirrhosis, and may have signs and symptoms of the same, which can include jaundice, altered mental status, evidence of decreased nutrition, and the presence of ascites.Specifically, the production of ascites that is resistant to the use of diuretic medications is characteristic of type 2 HRS.
The risk of death in hepatorenal syndrome is very high; the mortality of individuals with type 1 HRS is over 50% over the short term.The only long-term treatment option for the condition is liver transplantation. While awaiting transplantation, Some patients often receive other treatments such as insertion of a transjugular intrahepatic portosystemic shunt (TIPS), which is a small shunt placed to reduce blood pressure in the portal vein and hemodialysis to support kidney function.

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