Hepatorenal syndrome differential diagnosis: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
No edit summary |
||
| Line 10: | Line 10: | ||
==Differentiating Hepatorenal Syndrome from other Diseases== | ==Differentiating Hepatorenal Syndrome from other Diseases== | ||
Many other diseases of the kidney are associated with liver disease and must be excluded before making a diagnosis of hepatorenal syndrome. They include the following: | Many other diseases of the kidney are associated with liver disease and must be excluded before making a diagnosis of hepatorenal syndrome. They include the following: | ||
*[[Renal failure|Pre-renal failure]]: Pre-renal failure usually responds to treatment with intravenous fluids, resulting in reduction in serum [[creatinine]] and the excretion of sodium. | *[[Renal failure|Pre-renal failure]]: Pre-renal failure usually responds to treatment with intravenous fluids, resulting in reduction in serum [[creatinine]] and the excretion of sodium. | ||
*[[Acute tubular necrosis]] (ATN): This can be difficult to confidently diagnose. It may be an inability to concentrate the urine, if any is being produced. The urine sediment should be bland, microscopy may show [[hyaline cast]]s. ATN may recover with supportive treatment only or progress to [[end-stage renal failure]]. In cirrhosis, urinary sodium is not a reliable guide to the development of ATN, as [[fractional sodium excretion]] may stay below 1 percent, due to the gradual worsening of renal [[ischaemia]]. | *[[Acute tubular necrosis]] (ATN): This can be difficult to confidently diagnose. It may be an inability to concentrate the urine, if any is being produced. The urine sediment should be bland, microscopy may show [[hyaline cast]]s. ATN may recover with supportive treatment only or progress to [[end-stage renal failure]]. In cirrhosis, urinary sodium is not a reliable guide to the development of ATN, as [[fractional sodium excretion]] may stay below 1 percent, due to the gradual worsening of renal [[ischaemia]]. | ||
*Other causes may include [[glomerulonephritis|glomerular disease]] secondary to [[Hepatitis B]] or [[Hepatitis C]],<ref>Han SH. Extrahepatic manifestations of chronic hepatitis B. ''Clin Liver Dis.'' 2004 May;8(2):403-18. PMID 15481347</ref> drug toxicity (notably [[gentamicin]]) or [[Radiocontrast|contrast nephropathy]]. | *Other causes may include [[glomerulonephritis|glomerular disease]] secondary to [[Hepatitis B]] or [[Hepatitis C]],<ref>Han SH. Extrahepatic manifestations of chronic hepatitis B. ''Clin Liver Dis.'' 2004 May;8(2):403-18. PMID 15481347</ref> drug toxicity (notably [[gentamicin]]) or [[Radiocontrast|contrast nephropathy]]. | ||
Revision as of 13:25, 28 September 2012
|
Hepatorenal syndrome Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Hepatorenal syndrome differential diagnosis On the Web |
|
American Roentgen Ray Society Images of Hepatorenal syndrome differential diagnosis |
|
Risk calculators and risk factors for Hepatorenal syndrome differential diagnosis |
Please help WikiDoc by adding more content here. It's easy! Click here to learn about editing.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Differentiating Hepatorenal Syndrome from other Diseases
Many other diseases of the kidney are associated with liver disease and must be excluded before making a diagnosis of hepatorenal syndrome. They include the following:
- Pre-renal failure: Pre-renal failure usually responds to treatment with intravenous fluids, resulting in reduction in serum creatinine and the excretion of sodium.
- Acute tubular necrosis (ATN): This can be difficult to confidently diagnose. It may be an inability to concentrate the urine, if any is being produced. The urine sediment should be bland, microscopy may show hyaline casts. ATN may recover with supportive treatment only or progress to end-stage renal failure. In cirrhosis, urinary sodium is not a reliable guide to the development of ATN, as fractional sodium excretion may stay below 1 percent, due to the gradual worsening of renal ischaemia.
- Other causes may include glomerular disease secondary to Hepatitis B or Hepatitis C,[1] drug toxicity (notably gentamicin) or contrast nephropathy.
References
- ↑ Han SH. Extrahepatic manifestations of chronic hepatitis B. Clin Liver Dis. 2004 May;8(2):403-18. PMID 15481347