الفهرس | Only 14 pages are availabe for public view |
Abstract The International Ascites Club defined HRS as: “a syndrome that occurs in patients with advanced chronic liver disease, advanced hepatic failure and portal hypertension characterized by impaired renal function and marked abnormalities in the arterial circulation and activity of the endogenous vasoactive systems. In the kidney, there is marked renal vasoconstriction that results in low glomerular filtration rate (GFR). In the extrarenal circulation, there is a predominance of arterial vasodilatation that results in reduction of total systemic vascular resistance and arterial hypotension”. HRS accounts for 20% of acute renal failure inpatients with cirrhosis and ascites and about 17% of the patients with ascites admitted to hospital and in more than 50% of deaths occurring among cirrhotic patients with liver failure. There are four types of Hepatorenal syndrome: Type 1: Cirrhosis with rapidly progressive renal failure. Type 2: Cirrhosis with subacute renal failure. Type 3: Cirrhosis with types 1 or 2 HRS superimposed on chronic kidney disease or acute renal injury. Type 4: Fulminant liver failure with HRS. |