Hepatorenal syndrome

What is hepatorenal syndrome?

Hepatorenal syndrome (HRS) is a type of kidney failure seen in people who suffer severe liver damage from cirrhosis. As the kidneys stop functioning properly, less urine is removed from the body and toxins begin to accumulate in the bloodstream. As a result, it leads to liver damage and failure.

Prognosis

Hepatorenal syndrome is a serious complication of liver disease, as it leads to kidney failure and it can be fatal. Therefore, treating it is essential.

Hepatorenal syndrome symptoms

The main symptoms of hepatorenal syndrome should be treated as a medical emergency. They include are:

Abdominal bloating due to ascites, which is the buildup of fluid in the abdomen from liver disease

  • Dark or cloudy urine
  • Muscle spasms
  • Nausea and vomiting
  • Decreased urine
  • Mental confusion
  • Weight gain
  • Jaundice

Medical tests for hepatorenal syndrome

Currently, there are no specific tests to detect this syndrome, but rather after listening to the symptoms of the patient and a physical examination is done, liver problems are usually detected. Therefore, hepatorenal syndrome is normally diagnosed after ruling out other causes of kidney failure.

What are the causes of hepatorenal syndrome?

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

  • Liver failure
  • Cirrhosis
  • Alcoholic hepatitis
  • Infected abdominal fluid
  • Unstable blood pressure
  • Other infections

Can it be prevented?

The best way to prevent hepatorenal syndrome is to keep your liver healthy. To do this, it is important to avoid or treat the risk factors that lead to this problem:

  • Infections, such as hepatitis
  • Diuretic medications
  • Sudden changes in blood pressure
  • Puncture of abdominal fluid
  • Gastrointestinal bleeding

Treatments for hepatorenal syndrome

The treatment depends on the main cause but it aims to make the liver function better by filtering the urine, just like with the treatment for kidney failure. The steps to follow to treat hepatorenal syndrome are:

  • Dialysis to improve symptoms
  • Stop taking medications like antibiotics and unnecessary diuretics
  • Pharmacological treatment for blood pressure
  • Ascites drainage using a paracentesis or shunt

One of the possible treatments for this is a kidney transplant.

Which specialist treats hepatorenal syndrome?

A specialist that treats hepatorenal syndrome is a nephrologist. An Internal medicine specialist is also an expert in treating kidney diseases.