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Hepatorenal syndrome (HRS) is a form of impaired kidney function that occurs in individuals with advanced liver disease. If the kidney of an individual with hepatorenal syndrome were to be transplanted into an otherwise healthy individual, it is expected function normally. Why?
Patients with hepatorenal syndrome do not have any identifiable cause of kidney malfunction and the kidneys are not damaged structurally.
Hepatoreanl syndrome includes two types, type I and type II. The former one usually leads to kidney failure and is a rapidly progressive medical condition while type II usually develops slowly.
- Cirrhosis. HRS occurs in about 4% of patients admitted with decompensated cirrhosis, with a cumulative probability of 18% at 1 year and 39% at 5 years.
- Spontaneous bacterial peritonitis. Patients with spontaneous bacterial peritonitis will have a one-in-three chance of developing HRS.
- Finger clubbing
- Spider naevi
- palmar erythema
- Bleeding tendency
- Hepatic encephalopathy
- Oedema and ascites
- Low blood pressure. Patients will usually have low arterial blood pressure, wider pulse pressure and bounding pulses.
- Urine output reduction. The urine output will be drastically reduced, particularly in type 1 HRS.
- Usually type 1 HRS develops in patients with advanced chronic liver disease but it can also occur in patients with acute liver failure. In such a condition, you are suggested to monitor your fluid intake, urine output and blood chemistries at a regular basis.
- Outpatient setting. Patients with type 2 HRS are usually less sick and can be managed in an outpatient setting.
- Diuretics. If you suffer from severe edema, diuretics may be ordered. But the use of the medicine in Hepatorenal Syndrome requires very careful consideration due to the potential of worsening electrolytes and resistance to their actions.
To manage the Hepatorenal Syndrome, you need to take care both your kidneys and liver well. Besides, diet and exercise will help a lot.
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