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Hepatorenal Syndrome

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Liver Disorders

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Abstract

The hepatorenal syndrome (HRS) is a severe complication that occurs in patients with advanced cirrhosis, severe alcoholic hepatitis, and fulminant liver failure and is one of many possible causes of renal dysfunction in patients with cirrhosis. The hepatorenal syndrome represents the end result of significant hemodynamic derangement that is initiated by portal hypertension. It is characterized by intense intrarenal vasoconstriction in association with overt splanchnic vasodilatation and a relatively insufficient cardiac output. Type 1 HRS is associated with rapidly progressing renal failure with a natural course that lead to death at a median of 2 weeks while type 2 HRS is a more chronic form of HRS and is associated with a slower progression of renal failure and without treatment, the median survival is about 6 months. Current maximal supportive care, including systemic vasoconstrictors given in combination with intravenous albumin is only effective in 40–50 % of patients with the hepatorenal syndrome. Liver transplantation remains the best treatment option for suitable patients as it affords the chance for cure of the liver failure and also leads to resolution of the kidney failure.

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Authors and Affiliations

  1. Division of Nephrology, Medical College of Wisconsin, Milwaukee, WI, USA

    Michael M. Yeboah M.B.Ch.B., Ph.D.

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  1. Michael M. Yeboah M.B.Ch.B., Ph.D.
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Correspondence to Michael M. Yeboah M.B.Ch.B., Ph.D. .

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Editors and Affiliations

  1. Division of Gastroenterology and Hepatology, Medical College of Wisconsin , Milwaukee, Wisconsin, USA

    Kia Saeian

  2. Division of Gastroenterology and Hepatology, Medicine Medical College of Wisconsin , Milwaukee, Wisconsin, USA

    Reza Shaker

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Yeboah, M.M. (2017). Hepatorenal Syndrome. In: Saeian, K., Shaker, R. (eds) Liver Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-30103-7_32

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  • DOI: https://doi.org/10.1007/978-3-319-30103-7_32

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