Hepatorenal syndrome (GDS) - this is severe functional acute renal failure (ARF) in patients with severe hepatic insufficiency in the outcome of chronic liver disease – Cirrhosis of the liver, and , there is no other cause of renal failure.
Diagnostic criteria of GDS of the International Ascitic Club (2007):
- Cirrhosis of the liver with ascites
- Serum creatinine level greater than 1.5 mg / dl
- No current intake of nephrotoxic drugs
- Absence of parenchymal kidney diseases (proteinuria more than 500 mg / day, microhematuria, urinary tract obstruction by ultrasound)
Depending on the severity of clinical manifestations, there are two types of GDS:
The first type is acute, rapidly progressing (diagnosis is based on a twofold increase in the initial serum creatinine level of more than 2.5 mg/dl or a decrease in creatinine clearance by more than 50% -to a level of less than 20 ml/min for two weeks).
The prognosis of GDS of the first type is extremely unfavorable - the mortality rate is 80-90 % within two weeks.
The second type is characterized by a gradual, over several months, decrease in kidney function, which is determined by an increase in serum creatinine levels from 1.5 to 2.5 mg/dl. The main clinical syndrome of GRS type 2 is refractory ascites. The prognosis is better than in type 1 GDS, but worse than in the general population of CP patients with ascites.
Treatment of GDS:
Protein preparations (albumin)
Liver transplantation is the only reliable way to treat GDS.
Important! Taking into account the unfavorable prognosis in patients with cirrhosis of the liver with the development of functional renal failure, the search for new approaches to early diagnosis and treatment is a priority in the work of the Department of Hepatology of the TSNIIG.
Do not delay-seek qualified medical help!
Remember that a correct and timely diagnosis guarantees the effectiveness of treatment!
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