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00:01 An important understanding of Hepatorenal Syndrome is required. 00:07 This is a functional renal failure without underlying renal pathology. 00:12 This is not nephralic syndrome, this is not nephrotic syndrome nor it is arteriosclerosis taking place at the renal artery. 00:19 The perfectly functional kidney, used to be the patient developed portal hypertension and now, there is a functional renal failure Is that clear? Very interesting. Important? Yes. 00:35 Type I: Severe with rapid renal failure. 00:40 your GFR drops, mortality almost 100% So, from now on, whenever you have portal hypertension, you can now go beyond, just cure hepatic portal hypertension, can't you? An important topic. 00:55 Type II: Insidious drop in GFR. 00:58 Diagnosis of exclusion. 00:59 Here, you'll find that urine sodium is less than 10mEq/L urine sodium is less than 10mEq/L It means to say, it is not able to properly take care of sodium handling. 01:08 There is no established therapy which makes it really dangerous. 01:12 And after transplantation of liver, it seems as though the kidney actually comes back to life. 01:18 Fascinating. We don't know a whole lot about it but we know just enough, where that statistic of 100% mortality puts it on the radar, big time.
About the Lecture
The lecture Hepatorenal Syndrome by Carlo Raj, MD is from the course Cirrhosis – Liver Diseases.
Included Quiz Questions
What is the treatment of choice for patients with hepatorenal syndrome?
- Liver transplantation
- Chemotherapy
- Steroids
- Antibiotics
- Antihypertensives
Which of the following factors decides the type of hepatorenal syndrome?
- Rapidity in the loss of the renal function
- Amount of loss of renal function
- Severity of loss of renal function
- Severity of loss of hepatic function
- Rapidity of loss of hepatic function
Which of the following statements are NOT true regarding hepatorenal syndrome?
- Type 2 shows rapid loss of renal function
- There is type 1 and type 2 hepatorenal syndrome
- It is defined as the functional renal failure without underlying renal pathology secondary to portal hypertension
- Type 1 hepatorenal syndrome has a high rate of mortality.
- Hepatorenal syndrome is usually a diagnosis of exclusion with urine Na<20 mEq/L
Which of the following statements are true regarding hepatorenal syndrome?
- Hepatorenal syndrome type 1 is defined as at least a twofold increase in serum creatinine to a level greater than 2.5 mg/dL in less than two weeks.
- Type 2 shows rapid loss of renal function
- Hepatorenal syndrome is treated with steroids and antihypertensives
- Hepatorenal syndrome is usually diagnosed with certainty based on the renal function only
- Hepatorenal syndrome does not improve after liver transplantation
A patient is diagnosed with hepatorenal syndrome. What is the laboratory analysis of this patient?
- Serum creatinine - Increased Urine Na - Decreased Serum transaminases - Increased
- Serum creatinine - normal Urine Na - Decreased Serum transaminases - Increased
- Serum creatinine - Increased Urine Na - Decreased Serum transaminases - normal
- Serum creatinine - Increased Urine Na - increased Serum transaminases - Increased
- Serum creatinine - decreased Urine Na - Decreased Serum transaminases - decreased
A 48 year old man with cirrhosis is admitted to hospital with spontaneous bacterial peritonitis. His lab values show total bilirubin = 2.0mg/dl, Albumin level - 2.0g/dl, Creatinine is 1.2 and Urine Na = 8 mEq/L on hospitalisation. On day 6 his creatinine rises to 4.2 and is anuric. What is the diagnosis of the patient?
- Type i Hepatorenal syndrome
- Type 2 hepatorenal syndrome
- Hepatopulmonary syndrome
- Non alcoholic liver disease
- Cirrhosis with portal hypertension
Author of lecture Hepatorenal Syndrome
Carlo Raj, MD
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