Medical Treatment of Hepatorenal Syndrome - AASLD

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Site of Action of CurrentTherapies for HRSCirrhosisLiver transplantationTIPSPortal (sinusoidal)hypertensionSplanchnic/systemic vasodilatationEffective arterial blood volumeActivation of neurohumoral systemsVasoconstrictors+AlbuminRenalvasoconstrictionHRSTIPS, transjugular intrahepatic portosystemic shunt.
Renal ReplacementTherapy for HRS•No controlled studies of hemodialysis inHRS 1•Hemodialysis does not confer long-termsurvival without transplantation 2•Hemodialysis may be of benefit asbridge to transplantation for patientswith HRS 3 1. Gines P, et al. Nephrology. 1999;10:1833–1839.2. Witzke O, et al. J Gastroenterol Hepatol. 2004;19:1369–1373.3. Capling RK, et al. Ren Fail. 2004;26:563–568.
Page 1 and 2: Thomas D. Boyer, MDHepatorenal Synd
Page 3 and 4: Conflicts of interest• Member adv
Page 5 and 6: Pathogenesis of Ascites in Cirrhosi
Page 7 and 8: 7060504030252015105Neurohumoral Sys
Page 9 and 10: Type and Frequency of Injury inAcut
Page 11: Workup of Renal Dysfunction in Pati
Page 14 and 15: Hepatorenal syndromeAdditional Crit
Page 16 and 17: Type 1 HRS Is Associated WithVery P
Page 18 and 19: Who Develops HRS?•Cirrhotic patie
Page 20 and 21: Prevention of HRS
Page 22 and 23: Antibiotic Prophylaxis in VaricealB
Page 24 and 25: Prostaglandin Inhibition andEffects
Page 26 and 27: Treatment of HRS General• Stop al
Page 30 and 31: TIPS and HRSGut 47:166; 2000
Page 32 and 33: Treatment of HRS:Pharmacologic Ther
Page 34 and 35: Background (II)• Synthetic 12-ami
Page 36 and 37: Reversal of HRS40HRS Reversal (%)30
Page 38 and 39: Survival DistributionFunction1.00.9
Page 40 and 41: Adverse EventsTerlipressinN=56Place
Page 42 and 43: Impact of OLTx on RenalGlomerular f
Page 44 and 45: HRS conclusions continued• Exclus

Medical Treatment of Hepatorenal Syndrome - AASLD

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