Hepatorenal syndrome in cirrhosis: diagnostic, pathophysiological, and therapeutic aspects

TY - JOUR

T1 - Hepatorenal syndrome in cirrhosis

T2 - diagnostic, pathophysiological, and therapeutic aspects

AU - Busk, Troels M

AU - Bendtsen, Flemming

AU - Møller, Søren

PY - 2016/10/2

Y1 - 2016/10/2

N2 - INTRODUCTION: Renal failure is a common and serious complication in cirrhosis and represents a wide spectrum of etiologies. The hepatorenal syndrome (HRS) represents a distinct type of renal failure, only seen in cirrhotic patients with ascites. The diagnostic criteria, knowledge in the pathophysiology of renal failure and HRS, and treatment hereof, have evolved tremendously during the last decades, and it is the aim of this review to summarize these discoveries.AREAS COVERED: The focus will primarily be on treatment and prevention of renal failure and HRS, but areas concerning definition, diagnosis, including biomarkers, and pathophysiology, will also be covered through a comprehensive, critical reading of the latest literature, encompassing the most recent, updated, international guidelines, reviews and high-impact original literature. Expert commentary: The advances made in the understanding of the pathophysiology of HRS and other complications of cirrhosis within the recent decades, have provided the basis for improved diagnostic criteria and the development of treatments that have substantially increased survival rates in cirrhotic patients suffering from these conditions. Focus should, in the nearest future, be on continuing this positive development, thus further improving prognosis for cirrhotic patients with HRS.

AB - INTRODUCTION: Renal failure is a common and serious complication in cirrhosis and represents a wide spectrum of etiologies. The hepatorenal syndrome (HRS) represents a distinct type of renal failure, only seen in cirrhotic patients with ascites. The diagnostic criteria, knowledge in the pathophysiology of renal failure and HRS, and treatment hereof, have evolved tremendously during the last decades, and it is the aim of this review to summarize these discoveries.AREAS COVERED: The focus will primarily be on treatment and prevention of renal failure and HRS, but areas concerning definition, diagnosis, including biomarkers, and pathophysiology, will also be covered through a comprehensive, critical reading of the latest literature, encompassing the most recent, updated, international guidelines, reviews and high-impact original literature. Expert commentary: The advances made in the understanding of the pathophysiology of HRS and other complications of cirrhosis within the recent decades, have provided the basis for improved diagnostic criteria and the development of treatments that have substantially increased survival rates in cirrhotic patients suffering from these conditions. Focus should, in the nearest future, be on continuing this positive development, thus further improving prognosis for cirrhotic patients with HRS.

KW - Journal Article

U2 - 10.1080/17474124.2016.1196132

DO - 10.1080/17474124.2016.1196132

M3 - Review

C2 - 27248461

SN - 1747-4124

VL - 10

SP - 1153

EP - 1161

JO - Expert Review of Gastroenterology & Hepatology

JF - Expert Review of Gastroenterology & Hepatology

IS - 10

ER -