scholarly journals End‐stage liver disease: Management of hepatorenal syndrome

2021 ◽  
Vol 41 (S1) ◽  
pp. 119-127
Author(s):  
Ezequiel Mauro ◽  
Lucrecia Garcia‐Olveira ◽  
Adrián Gadano ◽  
Luca Valenti
Keyword(s):  
Liver Disease ◽  
Disease Management ◽  
Hepatorenal Syndrome ◽  
End Stage Liver Disease ◽  
End Stage

scholarly journals Hepatorenal Syndrome: Physiology, Diagnosis and Management

2018 ◽  
Vol 35 (03) ◽  
pp. 194-197 ◽  
Author(s):  
Joseph Chmielewski ◽  
Robert Lewandowski ◽  
Haripriya Maddur
Keyword(s):  
Liver Disease ◽  
Hepatorenal Syndrome ◽  
Hepatic Dysfunction ◽  
Underlying Liver Disease ◽  
Free Survival ◽  
Renal Vasoconstriction ◽  
End Stage Liver Disease ◽  
Widespread Implementation ◽  
Intrahepatic Portosystemic Shunt ◽  
End Stage

AbstractIndividuals 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.

Hepatorenal Syndrome

2019 ◽  
pp. 397-406
Author(s):  
François Durand ◽  
Claire Francoz ◽  
Joseph DiNorcia ◽  
Yuri S. Genyk ◽  
Mitra K. Nadim
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Volume Expansion ◽  
Poor Prognosis ◽  
Structural Changes ◽  
Hepatorenal Syndrome ◽  
Clear Distinction ◽  
End Stage Liver Disease ◽  
Tubular Necrosis ◽  
End Stage

Hepatorenal syndrome (HRS) occurs in patients with end-stage liver disease and results from the complex circulatory changes associated with cirrhosis, where splanchnic vasodilatation and effective hypovolemia play central roles. Although related to hypovolemia, HRS is not reversed by volume expansion. In theory, HRS is not associated with structural changes in the kidney and, thus, is fully reversible with liver transplantation. Improvement may be observed with vasoconstrictors such as terlipressin in combination with albumin. However, in the absence of transplantation, HRS is associated with an extremely poor prognosis, even in patients who respond to vasoconstrictors. It is important to differentiate HRS from acute tubular necrosis because the therapeutic approach to each is different. Recent biomarkers are helpful but do not allow a clear distinction.

scholarly journals Outcomes in patients of End Stage Liver Disease with Hepatorenal syndrome undergoing Living Donor Liver Transplant

HPB ◽  
2019 ◽  
Vol 21 ◽  
pp. S282-S283
Author(s):  
Srinivas Bojanapu ◽  
Vivek Mangla ◽  
Shailendra Lalwani ◽  
Siddarth Mehrotra ◽  
Samiran Nundy ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Transplant ◽  
Living Donor ◽  
Hepatorenal Syndrome ◽  
Donor Liver ◽  
End Stage Liver Disease ◽  
Living Donor Liver Transplant ◽  
Donor Liver Transplant ◽  
End Stage

Position Paper on Treatment of Hepatitis C in Romania, 2017. Part One

2017 ◽  
Vol 26 (2) ◽  
pp. 171-181 ◽  
Author(s):  
Liana Gheorghe ◽  
Ioan Sporea ◽  
Speranţa Iacob ◽  
Roxana Şirli ◽  
Anca Trifan ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Liver Disease ◽  
Hepatitis C ◽  
Limit Of Detection ◽  
Position Paper ◽  
Hcv Infection ◽  
Fixed Dose ◽  
Diagnostic Tools ◽  
End Stage Liver Disease ◽  
End Stage

Background & Aims: Hepatitis C Virus (HCV) infection is a common condition with endemic prevalence in some areas of the world. In Romania, the mean prevalence is about 3%. New treatments became available on the market in recent years and new drugs are in the pipeline. A re-evaluation of HCV therapy was considered mandatory. The Romanian Society of Gastroenterology and Hepatology undertook this task for the practitioners of this country.Methodology: A group of recognized experts was created who screened the available literature and the major available guidelines. A list of items requiring attention has been created. These items were discussed and rated. Decisions were taken by consensus.Recommendations: We present here the first of the two parts of our Society’s recommendations for chronic HCV infection treatment. An agreement was reached regarding the diagnostic tools, the assessment of severity and the up-dated therapy schedules.Conclusions: This Position Paper represents a guide for the assessment and the therapy of HCV infection. The recommendations are in concordance with other guidelines but are applied to the real-life conditions in this country.Abbreviations: DAAs: Direct-acting antivirals; DDIs: Drug-drug interactions; ESLD: End-stage liver disease; ESRD: End-stage renal disease; eGFR: Estimated glomerular filtration rate; EASL: European Association for the Study of the Liver; EMA: European Medicines Agency; FDA: US Food and Drug Administration; FDC: Fixed-dose combination; GT: Genotype; GRADE: Grading of Recommendations Assessment, Development and Evaluation; HCV: Hepatitis C virus; HCC: Hepatocellular carcinoma; LT: Liver transplantation; LLD: Lower limit of detection; MELD score: Mayo-Clinic End-Stage Liver Disease score; ANMDM: National Agency of Medicines and Medical Devices; PPIs: Proton pump inhibitors; PWID: People who inject drugs; RCT: Randomized controlled trial; RDT: Rapid diagnostic test; RAS: Resistance-associated substitution; SRGH: Romanian Society of Gastroenterology and Hepatology; SAE: serious adverse events; SPC: Summary of Product Characteristics; SVR: Sustained virologic response.

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