https://idwiki.org/index.php?action=history&feed=atom&title=Hepatorenal_syndrome 2026-04-04T09:34:02Z Revision history for this page on the wiki MediaWiki 1.43.6 https://idwiki.org/index.php?title=Hepatorenal_syndrome&diff=9332&oldid=prev 2022-08-28T22:30:00Z

<p><span class="autocomment">Type 1</span></p> <table style="background-color: #fff; color: #202122;" data-mw="interface"> <col class="diff-marker" /> <col class="diff-content" /> <col class="diff-marker" /> <col class="diff-content" /> <tr class="diff-title" lang="en"> <td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Older revision</td> <td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 22:30, 28 August 2022</td> </tr><tr> <td colspan="2" class="diff-lineno">Line 24:</td> <td colspan="2" class="diff-lineno">Line 24:</td> </tr> <tr> <td class="diff-marker"></td> <td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* Rule out other causes</div></td> <td class="diff-marker"></td> <td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* Rule out other causes</div></td> </tr> <tr> <td class="diff-marker"></td> <td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* Stop diuretics unless needed for management of volume status</div></td> <td class="diff-marker"></td> <td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* Stop diuretics unless needed for management of volume status</div></td> </tr> <tr> <td class="diff-marker" data-marker="−"></td> <td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>* Albumin +/- octreotide and midodrine</div></td> <td class="diff-marker" data-marker="+"></td> <td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>* <ins style="font-weight: bold; text-decoration: none;">[[</ins>Albumin<ins style="font-weight: bold; text-decoration: none;">]]</ins> +/- <ins style="font-weight: bold; text-decoration: none;">[[</ins>octreotide<ins style="font-weight: bold; text-decoration: none;">]]</ins> and <ins style="font-weight: bold; text-decoration: none;">[[</ins>midodrine<ins style="font-weight: bold; text-decoration: none;">]]</ins></div></td> </tr> <tr> <td class="diff-marker" data-marker="−"></td> <td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>** Also can try terlipressin (a vasopressin analogue)</div></td> <td class="diff-marker" data-marker="+"></td> <td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>** Also can try <ins style="font-weight: bold; text-decoration: none;">[[</ins>terlipressin<ins style="font-weight: bold; text-decoration: none;">]]</ins> (a vasopressin analogue)</div></td> </tr> <tr> <td class="diff-marker" data-marker="−"></td> <td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>* Norepinephrine if in ICU</div></td> <td class="diff-marker" data-marker="+"></td> <td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>* <ins style="font-weight: bold; text-decoration: none;">[[</ins>Norepinephrine<ins style="font-weight: bold; text-decoration: none;">]]</ins> if in ICU</div></td> </tr> <tr> <td class="diff-marker"></td> <td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* Transplantation can be curative</div></td> <td class="diff-marker"></td> <td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* Transplantation can be curative</div></td> </tr> <tr> <td class="diff-marker"></td> <td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br /></td> <td class="diff-marker"></td> <td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br /></td> </tr> <!-- diff cache key site7_mediawiki:diff:1.41:old-4251:rev-9332:wikidiff2=table:1.13.0:bc2a06be --> </table>

Aidan https://idwiki.org/index.php?title=Hepatorenal_syndrome&diff=4251&oldid=prev 2020-07-04T01:17:38Z

<p>Imported from text file</p> <p><b>New page</b></p><div>== Diagnostic Criteria ==<br /> <br /> * Cirrhosis with ascites<br /> * Serum creatinine &amp;gt;133 μmol/l (1.5 mg/dl)<br /> * No improvement of serum creatinine (decrease to a level of ⩽133 μmol/l) after at least 2 days with diuretic withdrawal and volume expansion with albumin. The recommended dose of albumin is 1 g/kg of body weight per day up to a maximum of 100 g/day.<br /> * Absence of shock<br /> * No current or recent treatment with nephrotoxic drugs<br /> * Absence of parenchymal kidney disease as indicated by proteinuria &amp;gt;500 mg/day, microhaematuria (&amp;gt;50 red blood cells per high power field) and/or abnormal renal ultrasonography<br /> <br /> == Classifications ==<br /> <br /> * &#039;&#039;&#039;Type 1&#039;&#039;&#039;<br /> ** Acute onset within 2 weeks of a precipitating factor for decompensated liver disease<br /> ** Usual triggers are severe alcoholic hepatitis and spontaneous bacterial peritonitis<br /> * &#039;&#039;&#039;Type 2&#039;&#039;&#039;<br /> ** Slowly-progressive renal failure in the context of refractory ascites<br /> ** Often with sodium retention<br /> ** Can progress into type 1 HRS<br /> <br /> == Management ==<br /> <br /> === Type 1 ===<br /> <br /> * Rule out other causes<br /> * Stop diuretics unless needed for management of volume status<br /> * Albumin +/- octreotide and midodrine<br /> ** Also can try terlipressin (a vasopressin analogue)<br /> * Norepinephrine if in ICU<br /> * Transplantation can be curative<br /> <br /> == Further Reading ==<br /> <br /> * [http://www.easl.eu/research/our-contributions/clinical-practice-guidelines/detail/management-of-ascites-spontaneous-bacterial-peritonitis-and-hepatorenal-syndrome-in-cirrhosis/report/6 EASL Guidelines 2010]<br /> <br /> [[Category:Respirology]]<br /> [[Category:Nephrology]]</div>

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