Keywords
Hepatorenal Syndrome
Liver
How to Cite
Copyright © | All rights reserved.
The journal holds the exclusive copyright for the publication of this article under the terms of Brazilian law 9610/98.
Partial reproduction
The use of parts of the texts, figures and questionnaire of the article is free, being mandatory the citation of the authors and journal.
Total reproduction
It is expressly prohibited and must be authorized by the journal.
Abstract
Objective: To analyze the characteristics of Hepatorenal Syndrome (HRS). Bibliographic review: HRS is defined as a deterioration in renal function that occurs in the context of severe chronic liver diseases, such as advanced cirrhosis or acute liver failure. It is characterized by a decrease in renal perfusion due to a severe reduction in effective circulating volume and massive activation of the endogenous vasoactive system that causes renal vasoconstriction in the context of systemic and splanchnic arterial vasodilation. Acute renal impairment occurs in approximately 27% to 53% of patients admitted to the hospital with decompensated cirrhosis and ascites. Final considerations: HRS is a serious and potentially fatal condition in patients with liver cirrhosis. Its rapid recognition is essential. Management includes removing and treating precipitants in order to mitigate damage. Furthermore, the use of albumin is essential, and vasoconstrictor agents such as terlipressin can also be used. The definitive treatment for the condition is liver transplantation, however this is not always readily available and not all patients meet the necessary conditions to undergo it.
References
BERA C, WONG F. Management of hepatorenal syndrome in liver cirrhosis: a recent update. Therap Adv Gastroenterol, 2022; 15: 17562848221102679.
CHANEY A. A Review for the Practicing Clinician: Hepatorenal Syndrome, a Form of Acute Kidney Injury, in Patients with Cirrhosis. Clin Exp Gastroenterol, 2021; 14: 385-396.
FERREIRA LM, et al. Cost effectiveness of using terlipressin to treat hepatorenal syndrome. Arq Gastroenterol, 2022; 59(2): 268-274.
FLAMM SL, et al. The Current Management of Hepatorenal Syndrome-Acute Kidney Injury in the United States and the Potential of Terlipressin. Liver Transpl, 2021; 27(8): 1191-1202.
FRANCOZ C, et al. Hepatorenal Syndrome. Clin J Am Soc Nephrol, 2019; 14(5): 774-781.
HASAN I, et al. Hepatorenal syndrome: pathophysiology and evidence-based management update. Rom J Intern Med, 2021; 59(3): 227-261.
JAMIL K, et al. The Hepatorenal Syndrome Patient Pathway: Retrospective Analysis of Electronic Health Records. Curr Ther Res Clin Exp, 2022; 96:100663.
JUNG CY, CHANG JW. Hepatorenal Syndrome: Current Concepts and Future Perspectives. Clin Mol Hepatol, 2023; 13.
KHAN S, LINGANNA M. Diagnosis and management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome. Cleve Clin J Med, 2023; 90(4): 209-213.
KIANI C, ZORI AG. Recent advances in pathophysiology, diagnosis and management of hepatorenal syndrome: A review. World J Hepatol, 2023; 15(6): 741-754.
MINDIKOGLU AL, PAPPAS SC. New Developments in Hepatorenal Syndrome. Clin Gastroenterol Hepatol, 2018; 16(2): 162-177.
MOHAMED MMG, et al. Terlipressin effect on hepatorenal syndrome: Updated meta-analysis of randomized controlled trials. JGH Open, 2021; 5(8): 896-901.
OJEDA-YUREN AS, et al. An Integrated Review of the Hepatorenal Syndrome. Ann Hepatol, 2021; 22:100236.
SMITH A, et al. Cirrhosis: Diagnosis and Management. Am Fam Physician, 2019; 100(12): 759-770.
SIMBRUNNER B, et al. Recent advances in the understanding and management of hepatorenal syndrome. Fac Rev, 2021; 10:48.
SUBEDI A, et al. A Review of Hepatorenal Syndrome. Cureus, 2021; 13(7): 16084.
TARIQ R, SINGAL AK. Management of Hepatorenal Syndrome: A Review. J Clin Transl Hepatol, 2020; 8(2): 192-199.
TIWARI N, WONG F. Hepatorenal syndrome: Updates. Clin Liver Dis (Hoboken), 2023; 22(2): 32-36.
WANG H, et al. Terlipressin in the treatment of hepatorenal syndrome: A systematic review and meta-analysis. Medicine (Baltimore), 2018; 97(16): e0431.
WILDE B, et al. Clinical and pathophysiological understanding of the hepatorenal syndrome: Still wrong or still not exactly right? World J Clin Cases, 2023; 11(6): 1261-1266.