Hepatorenal syndrome

What is hepatorenal syndrome?

Hepatorenal syndrome is a complication of liver cirrhosis, in which progressive renal failure occurs.

It is the consequence of the kidneys ceasing to function, so that less urine is eliminated from the body and nitrogen-containing wastes accumulate in the bloodstream. This process results in azotemia, which is the accumulation of nitrogenous waste products in the blood, which damages tissues and can affect organ function.

Prognosis of the disease

Hepatorenal syndrome is a serious complication of liver disease, as it leads to renal failure and can become fatal.

It is essential to treat this syndrome, as without treatment, it severely complicates the patient’s life expectancy.

Symptoms of hepatorenal syndrome

The main symptoms of hepatorenal syndrome are:

  • Abdominal swelling due to ascites, which is the accumulation of fluid due to liver disease.
  • Dark or cloudy urine.
  • Muscle spasms.
  • Nausea and vomiting.
  • Decreased urination.
  • Mental confusion due to hepatic encephalopathy.
  • Weight gain.
  • Jaundice or yellow skin.

The hepatorenal syndrome presents a similar symptomatology to liver cirrhosis.

Medical tests for hepatorenal syndrome

Currently there is no specific test to detect hepatorenal syndrome, but rather a physical examination and the patient’s symptoms are used to detect liver problems. Thus, hepatorenal syndrome is usually diagnosed after ruling out other causes of renal failure.

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What are the causes of hepatorenal syndrome?

Hepatorenal syndrome occurs in 1 in 10 people hospitalized for liver failure. Thus, the main causes are:

  • Liver failure
  • Cirrhosis
  • Alcoholic hepatitis
  • Infected abdominal fluid

Can it be prevented?

The best way to prevent hepatorenal syndrome is to avoid liver pathologies. To do so, it is important to prevent or treat the risk factors that lead to these problems:

  • Infections
  • Diuretic medications
  • Sudden changes in blood pressure
  • Abdominal fluid puncture
  • Gastrointestinal bleeding

Treatments for hepatorenal syndrome

Treatment aims to make the liver work better by filtering urine, as with treatment for kidney failure. The steps to follow to treat hepatorenal syndrome are:

  • Dialysis to improve symptoms.
  • Discontinue taking unnecessary medications such as antibiotics and diuretics.
  • Drug treatment for blood pressure.
  • Placing a shunt or drainage for ascites.

Which specialist treats you?

The nephrologist is the expert specialist in liver pathologies. Internal Medicine specialists are also experts in the treatment of renal pathologies.