Hepatorenal syndrome classification: Difference between revisions
Sunny Kumar (talk | contribs) No edit summary |
Sunny Kumar (talk | contribs) |
||
| Line 4: | Line 4: | ||
==Overview== | ==Overview== | ||
The classification of hepato-renal syndrome is based on the deteriorating function of kidney. | |||
==Classification== | ==Classification== | ||
The hepatorenal syndrome is defined as renal failure that occurs in the setting of liver disease as follows: | The hepatorenal syndrome is defined as renal failure that occurs in the setting of liver disease as follows: | ||
| Line 14: | Line 16: | ||
* Increase in serum [[creatinine]] level to greater than 133 μmol/L (1.5 mg/dL) or a creatinine clearance of less than 40 mL/min | * Increase in serum [[creatinine]] level to greater than 133 μmol/L (1.5 mg/dL) or a creatinine clearance of less than 40 mL/min | ||
* Urine sodium < 10 meq/dl<ref name="pmid3297907">{{cite journal |author=Ginés P, Arroyo V, Quintero E, ''et al'' |title=Comparison of paracentesis and diuretics in the treatment of cirrhotics with tense ascites. Results of a randomized study |journal=Gastroenterology |volume=93 |issue=2 |pages=234-41 |year=1987 |pmid=3297907 |doi=}}</ref> | * Urine sodium < 10 meq/dl<ref name="pmid3297907">{{cite journal |author=Ginés P, Arroyo V, Quintero E, ''et al'' |title=Comparison of paracentesis and diuretics in the treatment of cirrhotics with tense ascites. Results of a randomized study |journal=Gastroenterology |volume=93 |issue=2 |pages=234-41 |year=1987 |pmid=3297907 |doi=}}</ref> | ||
==== Classification on basis of mechanism of kidney injury in presence of liver failure: ==== | |||
# '''Hypovoluemia induced kidney injury:''' It occurs due to loss of fluid through GIT or GI bleed in presence of liver failure which predisposed kidney to hypovolumic injury. | |||
# '''Parencheymal renal disease:''' In presence protienurea above 500 mg/dl and hemeturia above 50 red cells points to kidney injury primarily otherwise it points to liver damage promoting kidney injury. | |||
# '''Drug induced hepato-nephrotoxicity:''' When drugs like acetaminophen and anti microbial causing hepatotoxicty and nephrotoxicity are taken together they can also produce combed damage. | |||
==References== | ==References== | ||
Revision as of 14:37, 5 December 2017
|
Hepatorenal syndrome Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Hepatorenal syndrome classification On the Web |
|
American Roentgen Ray Society Images of Hepatorenal syndrome classification |
|
Risk calculators and risk factors for Hepatorenal syndrome classification |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sunny Kumar MD [2]
Overview
The classification of hepato-renal syndrome is based on the deteriorating function of kidney.
Classification
The hepatorenal syndrome is defined as renal failure that occurs in the setting of liver disease as follows:
Type I HRS
Type I HRS is characterized by rapidly progressive renal failure with a doubling of serum creatinine to a level greater than 221 μmol/L (2.5 mg/dL) or a halving of the creatinine clearance to less than 20 mL/min over a period of less than 2 weeks.
Type II HRS
Type II HRS is characterized by a slowly progressive:
- Increase in serum creatinine level to greater than 133 μmol/L (1.5 mg/dL) or a creatinine clearance of less than 40 mL/min
- Urine sodium < 10 meq/dl[1]
Classification on basis of mechanism of kidney injury in presence of liver failure:
- Hypovoluemia induced kidney injury: It occurs due to loss of fluid through GIT or GI bleed in presence of liver failure which predisposed kidney to hypovolumic injury.
- Parencheymal renal disease: In presence protienurea above 500 mg/dl and hemeturia above 50 red cells points to kidney injury primarily otherwise it points to liver damage promoting kidney injury.
- Drug induced hepato-nephrotoxicity: When drugs like acetaminophen and anti microbial causing hepatotoxicty and nephrotoxicity are taken together they can also produce combed damage.