Abstract

The hepatorenal syndrome can be defined as unexplained renal failure in patients with hepatitis or cirrhosis of the liver in the absence of clinical or laboratory evidence of other causes of renal failure. The clinical features of hepatorenal syndrome include severe or advanced liver disease associated with jaundice, ascites, and often encephalopathy and rapid renal failure. This renal failure develops without any apparent precipitating events, such as dehydration or sepsis, and is characterized by a progressive, relentless oliguria. The oliguria and azotemia are not amenable to any known manipulation and thus are usually irreversible. Patients slowly lapse into coma, with hypotension and hypothermia, and die.1–3

Keywords

Hepatitis Ischemia Albumin Urea Dopamine 

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References

  1. 1.
    Vaamonde CA, Papper S: The kidney in liver disease, in Strauss and Welt’s Diseases of the Kidney ,ed 3. Boston, Little, Brown and Company, 1979, pp 1289–1317.Google Scholar
  2. 2.
    Shear L, Kleinerman J, Gabuzda GJ: Renal failure in patients with cirrhosis of the liver. 1. Clinical and pathologic characteristics. Am J Med 1965; 39:184–198.PubMedCrossRefGoogle Scholar
  3. 3.
    Wong PY, McCoy GC, Spielberg A, et al: The hepatorenal syndrome. Gastroenterolosy 1979 77:1326–1334.Google Scholar
  4. 4.
    Goresky CA, Kumar G: Renal failure in cirrhosis of the liver. Canad Med Assoc J 1964, 90:353–356.PubMedGoogle Scholar
  5. 5.
    Iwatsuki S, Popvtzer MM, Corman JL, et al: Recovery from “hepatorenal” syndrome after orthotopic liver transplantation. N Engl J Med 1973; 289:1155–1159.PubMedCrossRefGoogle Scholar
  6. 6.
    Koppel MH, Coburn JW, Mims MM, et al: Transplantation of cadaveric kidneys from patients with hepatorenal syndrome. N Engl J Med 1969; 280:1367–1371.PubMedCrossRefGoogle Scholar
  7. 7.
    Mandal AK, Lasing M, Fahmy A: Acute tubular necrosis in hepatorenal syndrome: An electron microscopy study. Am J Kid Dis 1982; 2:363–373.PubMedGoogle Scholar
  8. 8.
    Mandal AK, Sklar AH, Hudson JB: Transmission electron microscopy of urinary sediment in human acute renal failure. Kidney Int 1985; 28:58–63.PubMedCrossRefGoogle Scholar
  9. 9.
    Mandal AK: Transmission electron microscopy of urinary sediment in renal disease. Sem Nephrol 1986; 6:346–370.Google Scholar
  10. 10.
    Zipser RD, Radvan GH, Kronborg IJ: Urinary thromboxane B and prostaglandin E in the hepatorenal syndrome: Evidence for increased vasoconstrictor and decreased vasodilator factors. Gastroenterology 1983; 84:697–703.PubMedGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1987

Authors and Affiliations

  • Anil K. Mandal
    • 1
  1. 1.Wright State University, Veterans Administration Medical CenterDaytonUSA

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