Abstract
A considerable number of patients with advanced cirrhosis develop an initial hyperdynamic circulation and renal failure, which carry a poor prognosis. The hepatorenal syndrome denotes a progressive functional renal failure, owing to pronounced renal vasoconstriction, central hypovolemia, and low arterial perfusion pressure. Cirrhotic cardiomyopathy has been described as a condition with impaired contractile responsiveness to stress and altered diastolic relaxation. There are now several observations that indicate a relation between impaired renal function and decreased cardiac systolic function in advanced cirrhosis, in particular in patients with spontaneous bacterial peritonitis or refractory ascites. This has lent support to the hypothesis of a cardiorenal syndrome in cirrhosis. A cardiorenal syndrome refers to a condition where dysfunction of one of the organs affects the other, and implies that a cardiac systolic dysfunction in cirrhosis affects kidney function and survival in patients with advanced cirrhosis and renal failure. Thus, renal failure as well as cardiac dysfunction should be targets for new treatments that ameliorate abnormal systemic vascular resistance, effective blood volume, arterial blood pressure, and cardiac systolic function. Future research should confirm the hypothesis of a cardiorenal syndrome in cirrhosis and the potential principles of treatment.
| Original language | English |
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| Title of host publication | Ascites, Hyponatremia and Hepatorenal Syndrome: Progress in Treatment. |
| Number of pages | 10 |
| Volume | 28 |
| Place of Publication | Basel, Karger |
| Publication date | 21 Dec 2010 |
| Pages | 102-111 |
| Publication status | Published - 21 Dec 2010 |