Hepatorenal syndrome

Description of the disease

Hepatorenal syndrome is a condition in which kidney function is impaired due to chronic liver diseases (most commonly cirrhosis). Hepatorenal syndrome is a fairly common complication of liver cirrhosis (affects approximately 40% of patients).

Cause of the disease

The syndrome occurs when there is a kidney function impairment in liver diseases. Due to reduced urine excretion, harmful metabolic waste products accumulate in the body (azotemia).

Risk factors

Risk factors include: orthostatic hypotension (sudden drop in blood pressure upon standing), use of diuretic medications, gastrointestinal bleeding, infection.

Symptoms

Main symptoms characteristic of hepatorenal syndrome:

Ascites (accumulation of fluid in the abdominal cavity);
Decreased urine output, dark urine;
Weight gain;
Mental confusion (delirium);
Nausea, vomiting.

Diagnosis

Physical examination may reveal ascites (fluid in the abdominal cavity), confusion, jaundice. Blood tests reflecting liver and kidney function are performed, as well as evaluation of blood electrolyte balance. Urine output is monitored and measured.

Treatment

Hepatorenal syndrome is a very severe, life-threatening condition. One of the most important treatment methods is volume expansion (infusion of plasma, albumin). Medications such as midodrine, ornipressin, and various other drugs are prescribed. Treating this condition is very complex, often ending in death.

Source | Author Doctor Nikas Samuolis, reviewed by Prof. Virginijus Šapoka | Vilnius University | Faculty of Medicine | Head of the Department of Internal Medicine, Family Medicine, and Oncology