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Hepatorenal syndrome: current diagnostic and therapeutic concepts
Department of Internal Medicine I, General Internal Medicine, University of Bonn, Germany
Correspondence to: Michael Schepke, MD, HELIOS Klinikum Siegburg, Medizinische Klinik für Gastroenterologie und Hepatologie, Ringstr. 49, D-53721 Siegburg, Germany. Email: michael.schepke@helios-klinikum.de
| The first 150 words of the full text of this article appear below. |
Of the various complications in liver cirrhosis including intestinal bleeding, ascites and hepatocellular carcinoma, the rapidly progressive form of kidney dysfunction in cirrhosis, i.e. hepatorenal syndrome type 1, still carries the worst prognosis. In the early 1990s, median survival of these patients was reported to be as short as two weeks [1] and some more recent papers indicate that, in terms of prognosis, there has not been much progress since [2]. However, during the past two decades, new treatment concepts based on an improved pathophysiological understanding of the mechanisms ultimately leading to hepatorenal syndrome (HRS) have been introduced, and—very recently—a first randomized, controlled trial evaluating one of these concepts (i.e. vasoconstrictor treatment with the vasopressin analogue terlipressin) has been published in abstract form [3]. Despite successful drug treatment approaches, to date, the only definitive treatment of HRS type 1 is liver transplantation or even
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Pathophysiological background |
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Diagnosis, incidence and prognosis
Prevention and treatment
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