ACTA FAC. MED. NAISS. 2004; 21 (1): 9-14

 Reviewl article
 

HEPATORENAL SYNDROME - PATHOPHYSIOLOGICAL, CLINICAL AND TREATMENT CONSIDERATIONS

Suzana Raičević Sibinović¹, Aleksandar Nagorni¹, Radomir Raičević², Vesna Brzački¹, Miroslav Stojanović³, Daniela Benedeto- Stojanov¹, Nebojša Ignjatović³

¹ Clinic of Gastroenterology and Hepatology Clinical Center of Nis, Serbia
² Institut of Nephrology and Haemodialisis Clinical Center of Nis, Serbia
³ Clinic of Syrgery Clinical Center of Nis, Serbia

SUMMARY

Hepatorenal Syndrome (HRS) is a difficult complication that appears in patients with liver cirrhosis and ascites, and is characterized by significant deterioration of renal functions with significant sodium retention and oliguria. At the same time the real cause for this kidney disease cannot be found. The exact mechanisms of these changes have not been found but, it is considered that the disorder in the hemodynamics of kidneys themselves is the cause. The structure of kidneys is usually unchanged, and the urine analyses and pyelogram are normal. The main symptoms in a HRS are deterioration of azotemia, hyponatremia, progressive oliguria, and hypotension. This syndrome can be precipitated by difficult bleeding from digestive system, sepsis, forced diuresis or paracentesis. The treatment usually does not have much effect.

Key words: hepatorenal syndrome, liver cirrhosis, ascites