the intravascular volume) using intravenous albumin infusions has been shown to decrease the frequency of hepatorenal syndrome and, for that reason, improves survival rates in patients who develop SBP (Sort et al.
Hepatorenal syndrome is the deterioration of kidney function in patients who have acute or chronic liver failure but otherwise healthy kidneys.
The majority of patients who will develop hepatorenal syndrome will first develop diuretic-resistant ascites, usually with very low sodium in the urine (i.
Hepatorenal syndrome is thought to result from a severe contraction of the artery that feeds the kidney, which may occur as a response to excessive relaxation of the vessels in the rest of the body and a relatively low volume of blood inside the vascular system.
Several strategies have been used to reverse hepatorenal syndrome.
In the United States, neither ornipressin nor terlipressin is available, and the most popular intervention for hepatorenal syndrome is to expand blood volume using intravenous albumin, then to administer midodrine and octreotide to regulate vascular contraction (Angeli et al.
In addition, hepatorenal syndrome has been treated using high doses of antioxidants (Holt et al.
Although these treatments are available, hepatorenal syndrome will very likely recur, and patients should be moved quickly in the direction of possible liver transplantation.
Incidence, predictive factors, and prognosis of the hepatorenal syndrome in cirrhosis with ascites.
Effects of terlipressin administration with and without albumin in hepatorenal syndrome (HRS).
Reversibility of hepatorenal syndrome by prolonged administration of ornipressin and plasma volume expansion.