Salerno, Francesco; Gerbes, Alexander; Ginès, Pere; Wong, Florence; Arroyo, Vicente
September 2007
Gut;Sep2007, Vol. 56 Issue 9, p1310
Academic Journal
Hepatorenal syndrome (HRS) is a serious complication of end-stage liver disease, occurring mainly in patients with advanced cirrhosis and ascites, who have marked circulatory dysfunction, as well as in patients with acute liver failure. In spite of its functional nature, HRS is associated with a poor prognosis, and the only effective treatment is liver transplantation. During the 56th Meeting of the American Association for the Study of Liver Diseases, the International Ascites Club held a Focused Study Group (FSG) on HRS for the purpose of reporting the results of an international workshop and to reach a consensus on a new definition, criteria for diagnosis and recommendations on HRS treatment. A similar workshop was held in Chicago in 1994 in which standardised nomenclature and diagnostic criteria for refractory ascites and HRS were established. The introduction of innovative treatments and improvements in our understanding of the pathogenesis of HRS during the previous decade led to an increasing need to undertake a new consensus meeting. This paper reports the scientific rationale behind the new definitions and recommendations. The international workshop included four issues debated by four panels of experts (see Acknowledgements). The issues were: (1) evidence-based HRS pathogenesis; (2) treatment of HRS using vasoconstrictors; (3) other HRS treatments using transjugular intrahepatic portosystemic stent-shunt (TIPS) and extracorporeal albumin dialysis (ECAD); and (4) new definitions and diagnostic criteria for HRS and recommendations for its treatment.


Related Articles

  • Diagnosis and management of acute kidney injury in patients with cirrhosis: revised consensus recommendations of the International Club of Ascites. Angeli, Paolo; Gines, Pere; Wong, Florence; Bernardi, Mauro; Boyer, Thomas D.; Gerbes, Alexander; Moreau, Richard; Jalan, Rajiv; Sarin, Shiv K.; Piano, Salvatore; Moore, Kevin; Lee, Samuel S.; Durand, Francois; Salerno, Francesco; Caraceni, Paolo; Kim, W. Ray; Arroyo, Vicente; Garcia-Tsao, Guadalupe // Gut;Apr2015, Vol. 64 Issue 4, p531 

    The article offers information on the diagnosis and management of acute kidney injury in patients with cirrhosis. It mentions that acute renal failure (ARF) is a common complication in patients with decompensated cirrhosis. It also mentions that the traditional diagnostic criteria of renal...

  • Hepatorenal Syndrome: Outcome of Response to Therapy and Predictors of Survival. Heidemann, Jan; Bartels, Christoph; Berssenbrügge, Christoph; Schmidt, Hartmut; Meister, Tobias // Gastroenterology Research & Practice;4/23/2015, Vol. 2015, p1 

    Aim. Treatment of hepatorenal syndrome (HRS) in patients with liver cirrhosis is still challenging and characterized by a very high mortality. This study aimed to delineate treatment patterns and clinical outcomes of patients with HRS intravenously treated with terlipressin. Methods. In this...

  • Pharmacotherapy of Hepatorenal Syndrome. Bernardo, Christian M.; Bernardo, Angelito A. // Kidney;Jul/Aug2005, Vol. 14 Issue 4, p151 

    Provides information on several pharmacological treatments of hepatorenal syndrome. Vasopressin; Noradrenalin; N-Acetylcysteine.

  • Acute kidney injury: responding to the deficits in management and care. Sedgewick, John // Renal Society of Australasia Journal;Jul2011, Vol. 7 Issue 2, p53 

    The author reflects on the management and care of patients with acute kidney injury. He suggests that acute kidney injury is a complex and challenging disorder to manage. He argues that acute kidney injury is a life threatening problem which requires all members of a medical care team to work...

  • Renal failure in chronic liver disease and the hepatorenal syndrome. Srivastava, Brijesh; Alexander, Graeme J. M. // British Journal of Hospital Medicine (17508460);Sep2011, Vol. 72 Issue 9, p497 

    The article focuses on the aetiology and treatment of renal failure in chronic liver disease or liver cirrhosis, and explains the hepatorenal syndrome. It offers information on the circulatory disturbances in cirrhosis, and explores the investigations required in acute kidney injury. The article...

  • Clinical relevance of visit-to-visit blood pressure variability: impact on renal outcomes. Parati, G; Liu, X; Ochoa, J E // Journal of Human Hypertension;Jul2014, Vol. 28 Issue 7, p403 

    An impaired renal function has been found associated with very high cardiovascular (CV) risk, especially in subjects with type 2 diabetes. Microalbuminuria is a sensitive early marker of renal damage, often preceding the more advanced stages of diabetic nephropathy. Consistent evidence has been...

  • Improving patients outcomes: acute kidney injury. Patel, Ankur // Journal of Renal Nursing;2012, Vol. 4 Issue 3, p131 

    Acute kidney injury (AKI) is a serious illness that can develop suddenly, even in previously healthy patients. Recovery may be slow and, in some patients, AKI can lead to chronic kidney disease (CKD) and death. Ankur Patel describes the urgency of this illness-for the patient as well as society...

  • Acute kidney injury and rhabdomyolysis due to multiple wasp stings. Radhakrishnan, Hemachandar // Indian Journal of Critical Care Medicine;Jul2014, Vol. 18 Issue 7, p470 

    In most patients, wasp stings cause local reactions and rarely anaphylaxis. Acute kidney injury and rhabdomyolysis are unusual complications of wasp stings. We report a case of acute kidney injury and rhabdomyolysis secondary to multiple wasp stings. A 55-year-old farmer developed multi organ...

  • Molecular adsorbent recirculating system is ineffective in the management of type 1 hepatorenal syndrome in patients with cirrhosis with ascites who have failed vasoconstrictor treatment. Wong, Florence; Raina, Nilima; Richardson, Robert // Gut;Mar2010, Vol. 59 Issue 3, p381 

    Background The pathogenetic mechanism of hepatorenal syndrome (HRS) is paradoxical renal vasoconstriction consequent upon systemic and splanchnic arterial vasodilatation. Molecular adsorbent recirculating system (MARS) is a specialised form of dialysis that clears albumin-bound substances,...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics