The Internet Book of Critical Care Podcast IBCC Episode 116 - Hepatorenal Syndrome
30 snips
Aug 16, 2021 AI Snips
Chapters
Transcript
Episode notes
Hepatorenal Syndrome Pathophysiology
- Hepatorenal syndrome involves systemic vasodilation with compensatory renal vasoconstriction leading to kidney hypoperfusion.
- Over time, untreated hepatorenal syndrome can transition from a reversible pre-renal state to acute tubular necrosis.
HRS Nomenclature Update
- Hepatorenal syndrome type 1 is an acute kidney injury often seen in ICU and ER, whereas type 2 is a chronic kidney disease usually managed outpatient.
- The updated nomenclature aligns HRS type 1 with acute kidney injury (HRS-AKI) and type 2 with chronic kidney disease (HRS-CKD).
Preventing Hepatorenal Syndrome
- Avoid nephrotoxins like NSAIDs, ACE inhibitors, and ARBs in advanced cirrhosis patients.
- Administer albumin during large volume paracentesis (>3-5 liters) to prevent and stabilize hepatorenal syndrome.