Hepatorenal syndrome - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Urinary Systems.

hepatorenal syndrome is a serious complication of advanced liver disease, in which there is a development of renal failure in the absence of clinical, laboratory or anatomical features of any other reasons for renal dysfunction.This is usually accompanied by renal failure oliguria, the presence of normal urine sediment and low concentration of sodium in the urine (less than 10 mmol / l).The disease develops in advanced liver cirrhosis complicated with jaundice, ascites and hepatic encephalopathy.Sometimes, this syndrome can be a complication of fulminant hepatitis.

mechanism of this type of renal failure is unknown.The absence of persistent histopathological changes of kidney patients and restore normal renal function when kidneys suffering hepatorenal syndrome donors transplanted recipients with a healthy liver, suggesting that the violation has a functional nature.

treatment of hepatorenal syndrome

Treatment of patients with hepatorenal syndrome is usually unsuccessful.In the treatment of patients

with liver cirrhosis should be careful not to cause a significant change in the volume of liquid vnutosudistoy through aggressive diuresis or paracentesis, t. E. Procedures that can accelerate the development of hepatorenal syndrome.Because this syndrome mimics pre-renal azotemia, can be considered justified a cautious attempt to achieve increased vnutosudistoy liquid.In some cases, there is a restoration of renal function after portocaval bypass overlay abdominal-venous shunt (Leveen) or long-term hemodialysis.However, these treatments have not been sufficient study in controlled trials.Overlay abdominally-venous shunt may be associated with the development of peritonitis vnutosudistym blood coagulation and blood stasis in the lungs.

Improving liver function is often accompanied by simultaneous improvement of renal function.It is necessary to make every possible effort to ensure the absence of more specific and measurable correction of the reasons for the simultaneous dysfunction of the liver and the kidneys, such as infectious disease (leptospirosis. Hepatitis, accompanied by disease of immune complexes), toxins (aminoglycosides, carbon tetrachloride) and circulatory disorders (severe heart failure,shock).It should also be borne in mind that suffering from jaundice, and liver disease are particularly sensitive to facial acute necrosis of the renal tubules.