• Med. Clin. North Am. · Jul 2023

    Review

    Hepatorenal Syndrome: Pathophysiology, Diagnosis, and Treatment.

    • Justin M Belcher.
    • Section of Nephrology, Yale University School of Medicine, VA Connecticut Healthcare System, VA Connecticut Healthcare, Room G126B, 950 Campbell Avenue, West Haven, CT 06516, USA. Electronic address: Justin.belcher@yale.edu.
    • Med. Clin. North Am. 2023 Jul 1; 107 (4): 781792781-792.

    AbstractHepatorenal syndrome (HRS) is a primarily functional form of acute kidney injury (AKI) that develops in patients with decompensated cirrhosis. The pathophysiologic cascade that leads to HRS begins with pooling of blood in the splanchnic system, resulting in a decrease in effective circulating arterial volume. The definitive treatment of HRS is liver transplantation. When this is not possible, HRS is treated with a combination of vasoconstrictor agents and intravenous albumin. Although the combination of midodrine and octreotide is used in the United States, the recently approved terlipressin, an analog of vasopressin, is likely to become the first-line standard of care.Published by Elsevier Inc.

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