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Hepatorenal syndrome (HRS)

 

Epidemiology of hepatorenal syndrome (HRS)

  • 10% of patients with cirrhosis and ascites.

 

Pathogenesis hepatorenal syndrome (HRS)

  • Renal vasoconstriction leading to renal failure.
  • The renal vasoconstriction is a compensatory effect of RAAS and ADH, triggered by an extreme underfilling in the arterial circulation.

 

Types of hepatorenal syndrome (HRS)

  • Type 1
    • Rapidly progressive
    • Triggered by an event such as SBP and requiring urgent intervention
  • Type 2
    •  Occurs gradually, as a consequence of aggravation of end-stage liver disease

 

Treatment of hepatorenal syndrome (HRS)

  • Plasma expander, normally human albumin solution
  • Terlipressin 0.5-2mg IV four times daily

 

 

Click here to download free teaching notes on HRS in the context of decompensated chronic liver disease: Hepatorenal syndrome (HRS)

Perfect revision for medical students, finals, OSCEs and MRCP PACES