Hepatorenal syndrome differential diagnosis
|
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 |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sunny Kumar MD [2]
Overview
Many other diseases of the kidney are associated with liver disease and must be excluded before making a diagnosis of hepatorenal syndrome.
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:[1][2][3][4][5]
| Variables | Kidney injury associated with infection | Prerenal acute kidney injury | Hepatorenal syndrome | Parenchymal renal disease |
|---|---|---|---|---|
| Mechanism
Causes |
Infections, including SBP | Hypovolumia due:
gastrointestinal fluid losses bleeding diuretic |
Splanic vasodalation due to nitic oxide | Aminoglycoside therapy
Sepsis |
| Diagnostic clue | History of fever
Ascetic cultures |
History of:
Bleeding Low blood pressure Intake of NSAID |
Diagnosis of exclusion:
Liver failure + Renal failure no apparent cause for the acute kidney injury No improvement on removing nephrotoxic agent repleating fluid loss |
History of:
Injection of Dye intake of nephrotoxic agent |
| Prognosis | Good | Good | Poor | Good |
References
- ↑ Salerno F, Gerbes A, Ginès P, Wong F, Arroyo V (2007). "Diagnosis, prevention and treatment of hepatorenal syndrome in cirrhosis". Gut. 56 (9): 1310–8. doi:10.1136/gut.2006.107789. PMC 1954971. PMID 17389705.
- ↑ Martín-Llahí M, Guevara M, Torre A, Fagundes C, Restuccia T, Gilabert R, Solá E, Pereira G, Marinelli M, Pavesi M, Fernández J, Rodés J, Arroyo V, Ginès P (2011). "Prognostic importance of the cause of renal failure in patients with cirrhosis". Gastroenterology. 140 (2): 488–496.e4. doi:10.1053/j.gastro.2010.07.043. PMID 20682324.
- ↑ Verna EC, Brown RS, Farrand E, Pichardo EM, Forster CS, Sola-Del Valle DA, Adkins SH, Sise ME, Oliver JA, Radhakrishnan J, Barasch JM, Nickolas TL (2012). "Urinary neutrophil gelatinase-associated lipocalin predicts mortality and identifies acute kidney injury in cirrhosis". Dig. Dis. Sci. 57 (9): 2362–70. doi:10.1007/s10620-012-2180-x. PMC 3979299. PMID 22562534.
- ↑ Ginès P, Schrier RW (2009). "Renal failure in cirrhosis". N. Engl. J. Med. 361 (13): 1279–90. doi:10.1056/NEJMra0809139. PMID 19776409.
- ↑ Arroyo V, Ginès P, Gerbes AL, Dudley FJ, Gentilini P, Laffi G, Reynolds TB, Ring-Larsen H, Schölmerich J (1996). "Definition and diagnostic criteria of refractory ascites and hepatorenal syndrome in cirrhosis. International Ascites Club". Hepatology. 23 (1): 164–76. doi:10.1002/hep.510230122. PMID 8550036.