Hepatorenal Syndrome
What is hepatorenal syndrome?
Hepatorenal syndrome is caused by cirrhosis. The liver damage prevents the kidneys from working as they should.
What are the causes?
The liver is a complex organ. Its job is to process food, get rid of waste, and help blood to clot. The kidneys get rid of waste too. The waste from kidneys turns into urine. The kidneys and the liver filter the waste from blood. When the liver is damaged, blood cannot flow through the liver as it should. It backs up into the abdomen and makes it bigger. It also prevents blood from flowing to the kidneys. Because the kidneys cannot get the blood flow they need, they cannot filter waste from the blood to make urine.
What are the symptoms?
Some people have no symptoms of kidney problems. Some people make less urine and it changes color. They may also have symptoms in the rest of their body. For instance, they may have lower back pain, swelling, high blood pressure, fevers, nausea, and joint pain. They may become confused, feel more tired, and feel less hungry.
How is it treated?
Most people take medicine to treat hepatorenal syndrome. Medicine does not cure it, but it helps prevent more damage to the kidneys. The medicine will increase the amount of blood going to the kidneys. This helps the kidneys get rid of more waste. Two common medicines are midodrine and octreotide. Midodrine is a pill that will increase blood pressure which causes an increase in blood flow to the kidneys. There are hormones in your body that cause blood to flow away from your kidneys. Octreotide prevents these hormones from acting. Ask your doctor, pharmacist, or nurse what medicine you are taking to treat hepatorenal syndrome.
When the kidneys do not filter out enough waste, some people start dialysis. Dialysis is a process that filters the blood and helps it get rid of waste. You need to be hooked up to a machine for three or more hours, most often 3 times per week.
A liver transplant is the only cure for liver failure. After some people receive a liver transplant, their kidneys begin working again. Some people have too much kidney damage, and they will need a kidney transplant too. Your doctor will decide if you need both a kidney and a liver transplant or just a liver transplant.
References
- Rose, B.D & Runyon B. A. (2007) Diagnosis and treatment of hepatorenal syndrome. UpToDate. Retrived December 20, 2007 from http://www.utdol.com/utd/content/topic.do?topicKey=fldlytes/17148&selectedTitle=1~62&source=search_result. Cárdenas, A. & Gines, P. (2006) Hepatorenal syndrome. Clin. Liver Dis. 10, pp 371-385.
- Post, T.W. & Rose, B.D. (2007) Diagnostic approach to the patient with acute or chronic kidney disease. UpToDate. Retrieved December 20, 2007 from http://www.utdol.com/utd/content/topic.do?topicKey=renldis/19906&selectedTitle=22~150&source=search_result
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Last Updated: 12/19/2008
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