Hepatorenal syndrome is a serious complication that usually manifests itself in people with advanced liver disease, such as cirrhosis or liver failure, which is also characterized by a degradation of kidney function, where strong vasoconstriction occurs, resulting in a marked reduction in the rate of glomerular filtration and consequently to acute renal failure. On the other hand, extra-renal vasodilation occurs, leading to systemic hypotension.
Hepatorenal syndrome is a generally fatal condition, unless a liver transplant is performed, which is the treatment of choice for this condition.
Types of Hepatorrenal Syndrome
Two types of hepatorrenal syndrome can occur. Type 1, which is associated with rapid kidney failure and excess creatinine production, and type 2, which is associated with slower kidney failure, which is accompanied by more subtle symptoms.
Possible causes
Generally, hepatorrenal syndrome is caused by cirrhosis of the liver, the risk of which may increase if alcoholic beverages are ingested, kidney infections occur, if the person has unstable blood pressure, or if he uses diuretics.
In addition to cirrhosis, other diseases associated with chronic and severe liver failure with portal hypertension, such as alcoholic hepatitis and acute liver failure can also give rise to hepatorrenal syndrome. Learn how to identify liver cirrhosis and how the disease is diagnosed.
These liver disorders lead to a strong vasoconstriction in the kidneys, which results in a marked reduction in the glomerular filtration rate and consequent acute renal failure.
What symptoms
The most common symptoms that can be caused by hepatorrenal syndrome are jaundice, reduced urine output, darkened urine, abdominal swelling, confusion, delirium, nausea and vomiting, dementia and weight gain.
How the treatment is done
Liver transplantation is the treatment of choice for hepatorrenal syndrome, which allows the kidneys to recover. However, dialysis may be necessary to stabilize the patient. Find out how hemodialysis is done and what the risks of this treatment are.
The doctor may also prescribe vasoconstrictors, which contribute to decrease the endogenous activity of the vasoconstrictors, increasing the effective renal blood flow. In addition, they are also used to correct blood pressure, which is usually low after dialysis. The most widely used are vasopressin analogues, such as terlipressin, for example, and alpha-adrenergics, such as adrenaline and midodrine.
