A Comprehensive Systematic Review of the Latest Management Strategies for Hepatorenal Syndrome: A Complicated Syndrome to Tackle.

Autor:	Roy P; Internal Medicine, Harlem Hospital Center, New York, USA., Minhaz N; Internal Medicine, Dhaka Medical College, Dhaka, BGD., Shah-Riar P; Internal Medicine, Ibn Sina Medical College, Dhaka, BGD., Simona SY; Internal Medicine, Khulna Medical College, Khulna, BGD., Tasha T; Internal Medicine, Rajshahi Medical College, Rajshahi, BGD., Binte Hasan T; Internal Medicine, Armed Forces Medical College, Dhaka, BGD., Abbasi FK; Internal Medicine, Community Based Medical College, Bangladesh, Mymensingh, BGD., Alam F; Internal Medicine, Chittagong Medical College, Chittagong, BGD., Nila SA; Internal Medicine, Cumilla Medical College and Hospital, Cumilla, BGD., Akter J; Internal Medicine, Gonoshasthaya Samaj Vittik Medical College, Dhaka, BGD.; Internal Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, BGD., Akter S; Internal Medicine, Shaheed Ziaur Rahman Medical College, Bogura, BGD., Biswas S; Internal Medicine, Sir Salimullah Medical College Mitford Hospital, Dhaka, BGD., Sultana N; Internal Medicine, Sir Salimullah Medical College Mitford Hospital, Dhaka, BGD.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2023 Aug 07; Vol. 15 (8), pp. e43073. Date of Electronic Publication: 2023 Aug 07 (Print Publication: 2023).
DOI:	10.7759/cureus.43073
Abstrakt:	Hepatorenal syndrome (HRS), defined by the extreme manifestation of renal impairment in patients with cirrhosis, is characterized by reduced renal blood flow and glomerular filtration rate. It is diagnosed with reduced kidney function confirming the absence of intrinsic kidney disease, such as hematuria or proteinuria. HRS is potentially reversible with liver transplantation or vasoconstrictor drugs. The condition carries a poor prognosis with high mortality rates, particularly in patients with advanced cirrhosis. The latest management for HRS involves a combination of pharmacological and non-pharmacological interventions, aiming to improve renal function and reduce the risk of mortality. Pharmacological treatments include vasoconstrictors, such as terlipressin and midodrine, and albumin infusion, which have been shown to improve renal function and reduce mortality in HRS patients. Non-pharmacological interventions, including invasive procedures such as transjugular intrahepatic portosystemic shunt (TIPS), plasma exchange, liver transplantation, and renal replacement therapy, may also be considered. Though TIPS has been shown to be effective in improving renal function in HRS patients, liver transplantation remains at the top of the consideration for the treatment of end-stage liver disease and HRS. Recent studies have placed importance on early recognition and prompt intervention in HRS patients, as delaying treatment can result in poorer outcomes. Although there are numerous reviews that summarize various aspects of HRS, the recent advancements in the management and pathophysiology of HRS are still insufficient. Therefore, in this review, we summarized a brief pathophysiology and highlighted recent advancements in the management of HRS with a quick review of the latest articles. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2023, Roy et al.)
Databáze:	MEDLINE
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