The hepatorenal syndrome.

Population Based Trends in the Incidence of Hospital Admission for the Diagnosis of Hepatorenal Syndrome: 1998–2011

Background and Objectives. Hepatorenal syndrome carries a high risk of mortality. Understanding the incidence and mortality trends in hepatorenal syndrome will help inform future studies regarding the safety and efficacy of potential therapeutic interventions. Design and Methods. We conducted a retrospective cohort study using the Nationwide Inpatient Sample. We identified hospitalizations from...

Combined Liver-Kidney Transplantation for Hepatorenal Syndrome

Among various complications of end-stage liver disease, hepatorenal syndrome has the highest mortality. Patients with both end-stage liver disease and end-stage renal disease are candidates for combined liver-kidney transplantation. However, patients with cirrhosis with decompensation presenting in the form of hepatorenal syndrome, are also likely candidates for the procedure. Herein, we presen...

Hepatorenal Syndrome and Hyponatremia

• Hyponatremia and hepatorenal syndrome are complications that occur in patients with cirrhosis and ascites and represent a stage of “further” decompensation of cirrhosis • Worsened vasodilatation with consequent non-osmotic release of arginine-vasopressin and renal vasoconstriction are the main pathogenic mechanism for hyponatremia and hepatorenal syndrome, respectively • Both hyponatremia and...

Meta-analysis: terlipressin therapy for the hepatorenal syndrome.

BACKGROUND The hepatorenal syndrome is a severe and well-known complication of end-stage liver disease, but its management is controversial. Recent reports have shown the efficacy of terlipressin therapy, a vasopressin analogue, in hepatorenal syndrome patients. AIM To evaluate the efficacy and safety of terlipressin in the treatment of hepatorenal syndrome. METHODS We performed a systemati...

Towards goal-directed therapy of hepatorenal syndrome: we have the tools but we need the trials

Patients with cirrhosis who develop tense ascites and hepatorenal syndrome have a very high mortality and present a management challenge. Current debate stems from a lack of studies evaluating changes in effective arterial blood volume following paracentesis or targeting fluid replacement with appropriate vascular physiological measures to ensure no paracentesis-related circulatory dysfunction....

Hepatorenal Syndrome, Are we making any Progress?