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Saudi Journal of Kidney Diseases and Transplantation
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Year : 1996  |  Volume : 7  |  Issue : 3  |  Page : 277-282
Hepatorenal Syndrome

Department of Nephrology and Transplantation, Trie Royal Free Hospital, London, United Kingdom

Correspondence Address:
Paul Sweny
Department of Nephrology and Transplantation, The Royal Free Hospital, Pond Street, London MW3 2GQ
United Kingdom
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PMID: 18417943

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The hepatorenal syndrome (HRS) is a common complication of advanced liver disease. Careful management can reduce the risk of this functional renal failure developing in the vulnerable group of patients. Potentially nephrotoxic agents (drugs, x-ray contrast, etc.) need to be avoided wherever possible. It is likely that sympathetic overactivity, endotoxin, nitric oxide and endothelin, together with perturbed arachidonic acid metabolism, are closely involved in pathogenesis. Many of the associated abnormalities in HRS can be explained on the basis of an inadequate effective arterial blood volume and the resulting attempts at compensatory homeostasis. Medical management is disappointing, but trans-cutaneous intra-hepatic portal systemic shunting may help. Successful orthotopic liver transplantation is curative.

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