Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-26T20:32:56.123Z Has data issue: false hasContentIssue false

3.3.5 - Hepatorenal Syndrome and Hepatopulmonary Syndrome

from Section 3.3 - Acute Liver Failure

Published online by Cambridge University Press:  27 July 2023

By
Michael Spiro  and
Jeremy Fabes
Edited by
Ned Gilbert-Kawai ,
Debashish Dutta  and
Carl Waldmann
Ned Gilbert-Kawai
Affiliation:
The Royal Liverpool Hospital
Debashish Dutta
Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann
Affiliation:
Royal Berkshire Hospital, Reading
Get access

Summary

Key Learning Points

  1. 1. Hepatorenal syndrome (HRS) is the end result of progressive impairment of renal perfusion secondary to worsening hepatic failure.

  2. 2. HRS is a diagnosis of exclusion of acute kidney injury in chronic liver disease.

  3. 3. Both forms of HRS (types 1 and 2) have a poor prognosis, although HRS 1 typically leads to death within weeks.

  4. 4. Hepatopulmonary syndrome (HPS) develops from transpulmonary shunting, with resultant hypoxaemia.

Keywords

kidney injurykidney failureliver transplantationliver cirrhosishepatorenal syndromehepatopulmonary syndrome
Type
Chapter
Information
Intensive Care Medicine
The Essential Guide
 , pp. 171 - 173
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

References and Further Reading

Grace, JA, Angus, PW. Hepatopulmonary syndrome: update on recent advances in pathophysiology, investigation, and treatment. J Gastroenterol Hepatol 2013;28:213–19.CrossRefGoogle ScholarPubMed
Krowka, MJ, Fallon, MB, Kawut, SM, et al. International Liver Transplant Society Practice Guidelines: diagnosis and management of hepatopulmonary syndrome and portopulmonary hypertension. Transplantation 2016;100:1440–52.CrossRefGoogle ScholarPubMed
Salerno, F, Gerbes, A, Gines, P, Wong, F, Arroyo, V. Diagnosis, prevention and treatment of hepatorenal syndrome in cirrhosis. Gut 2007;56:1310–18.Google ScholarPubMed
Wong, F. The evolving concept of acute kidney injury in patients with cirrhosis. Nat Rev Gastroenterol Hepatol 2015;12:711–19.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×