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Semin intervent Radiol 2018; 35(03): 194-197
DOI: 10.1055/s-0038-1660797
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Hepatorenal Syndrome: Physiology, Diagnosis and Management

Joseph Chmielewski
1   Feinberg School of Medicine, Northwestern University, Chicago, Illinois
,
Robert J. Lewandowski
2   Section of Interventional Radiology, Department of Radiology, Northwestern University, Chicago, Illinois
3   Division of Hematology and Oncology, Department of Medicine, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois
4   Department of Surgery, Northwestern University, Chicago, Illinois
,
Haripriya Maddur
5   Division of Gastroenterology and Hepatology, Department of Medicine, Northwestern University, Chicago, Illinois
› Author Affiliations
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Publication History

Publication Date:
06 August 2018 (online)

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Abstract

Individuals with end-stage liver disease are susceptible to a myriad of highly morbid complications, including hepatorenal syndrome (HRS). This specific type of renal dysfunction in patients with underlying liver disease occurs in pathophysiologically normal kidneys and is a result of renal vasoconstriction secondary to diminished renal blood flow in the setting of worsening hepatic dysfunction. Liver transplantation is curative; shortage of available organs limits access to this beneficial therapy. Medical management of HRS has demonstrated increasing promise. Transjugular intrahepatic portosystemic shunt creation has also been shown to be efficacious in enhancing transplant-free survival, although further study is advisable before widespread implementation of this strategy.

Keywords

hepatorenal syndrome - pathophysiology - TIPS - terlipressin
 

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