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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Friday, April 22, 2011

Síndrome hepatorenal

Hepatorenal syndrome

Guevara M, Arroyo V; Expert Opinion on Pharmacotherapy (Apr 2011)

 Hospital Clinic Barcelona, Liver Unit, IDIBAPS, CIBERHED, Barcelona, Spain


(Solo se puede abrir desde un ordenador del Hospital)

Introduction: Renal failure in cirrhosis is a common complication that is associated with poor survival. A rapid diagnosis of the cause of renal failure is mandatory because it is associated with prognosis. Areas covered: This review covers the differential diagnosis between hepatorenal syndrome (HRS) and other causes of renal failure, as well as the difficulty in making a correct diagnosis, caused by the differentiation between hepatorenal syndrome and acute tubular necrosis. This review also discusses the multifactorial mechanisms involved in the pathogenesis of HRS. The paper provides diagnostic algorithms to use in clinical practice, emphasized by the fact that some patients may have HRS superimposed on pre-existent renal failure. Expert opinion: The correct diagnosis of renal failure is essential to initiate the correct treatment of this complication. In patients with HRS type 1, treatment with vasopressin and albumin is the treatment of choice; however, 50% of patients do not respond to this treatment.