Hepatorenal Syndrome in the Intensive Care Unit

Hani M. Wadei, Thomas A. Gonwa

Research output: Contribution to journalReview article

7 Scopus citations

Abstract

Hepatorenal syndrome (HRS) is a functional form of acute kidney injury (AKI) associated with advanced liver cirrhosis or fulminant hepatic failure. Various new concepts have emerged since the initial diagnostic criteria and definition of HRS was initially published. These include better understanding of the pathophysiological mechanisms involved in HRS, identification of bacterial infection (especially spontaneous bacterial peritonitis) as the most important HRS-precipitating event, recognition that insufficient cardiac output plays a role in the occurrence of HRS, and evidence that renal failure reverses with pharmacotherapy. Patients with HRS are often critically ill and, by definition, have multiorgan failure. The purpose of this review is to provide an update on novel advances in HRS, with emphasis on the different aspects of management of these patients in the intensive care unit.

Original languageEnglish (US)
Pages (from-to)79-92
Number of pages14
JournalJournal of Intensive Care Medicine
Volume28
Issue number2
DOIs
StatePublished - Mar 2013

Keywords

  • acute kidney injury
  • liver cirrhosis
  • liver transplantation
  • simultaneous liver-kidney transplantation
  • vasopressin analogs

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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