Hepatorenal Syndrome (HRS) is any renal failure (elevation of serum creatinine over 1,5 mg/dL or 24-hour creatinine clearance of less than 40%) that does not improve with the administration of up to 1,5 liters of plasma expanders that is concomitant with chronic hepatic disease, in the absence of parenchymal renal disease, obstructive uropathy, proteinuria of more than 500mg/d, shock of any kind, nephrotoxic drugs or fluid losses. It has a prevalence of 40% among cirrhotic patients and its mortality, if not treated, is 90% within 2 weeks and the 10% left die within 3 to 6 months of onset.
The only effective treatment to date is liver transplant, but the rapid progression of this syndrome usually denies this possibility. However, there are new treatment options that can revert this syndrome and help these patients.
HEPATIC
Pathophysiology:
There are many theories that try to explain the relation between liver and kidney, but the most widely accepted theory involves a disbalance of humoral and local vasoconstrictor and vasodilator factors on different vascular territories.
Lets consider their goals:
The combination of these treatments could lead to 65% to 75% survival rates.
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