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AKI in Cirrhosis - Hepatorenal Syndrome Management Algorithm

DOI: 10.1136/bmj.m2687

#AKI #Cirrhosis #Hepatorenal #Syndrome #HRS #Management #Algorithm #nephrology
in Cirrhosis - Hepatorenal ... Syndrome Management ... #Syndrome #HRS ... #Management #Algorithm ... #nephrology
Pharmacological Treatment of Hepatorenal Syndrome (HRS)

Midodrine - Alpha agonist incr blood pressure incr renal perfusion pressure
of Hepatorenal ... Syndrome (HRS) ... edgarvlermamd - Nephrology ... #Syndrome #Nephrology ... #Management #Pharmacology
Hepatorenal Syndrome Treatment
Volume expansion: 
 • Albumin (typical dose = 1g/kg on day 1 +/- day
Hepatorenal Syndrome ... Treatment Volume ... #Syndrome #Treatment ... #management #HRS ... #nephrology
Indications for Albumin for Management of Cirrhosis
 • Large volume paracentesis (>5 liter) - 8g per
for Albumin for Management ... antibiotics • Hepatorenal ... syndrome - 1g/ ... #Cirrhosis #treatment ... #hepatology
Korsakoff Syndrome
Clinical Findings:
 • Confabulation: Usually initial phase of the disease
 • Anterograde amnesia: Memory impairment
Korsakoff Syndrome ... Therefore, Korsakoff Syndrome ... Encephalopathy Treatment ... neudrawlogy #Korsakoff #Syndrome ... #neurology #diagnosis
Myelodysplastic Syndrome (MD) - Diagnosis and Management Summary
myelo (marrow) -dys- (abnormal) -plastic (shape) = funny-shaped cells
Myelodysplastic Syndrome ... cytopenias (usually anemia ... only curative treatment ... Myelodysplastic #Syndrome ... #treatment #hematology
Hepatorenal Syndrome - Diagnosis and Management Summary
Who gets HRS?
 • Decompensated cirrhosis
 • Typically with existing
Hepatorenal Syndrome ... Diagnosis and Management ... though limited data ... #Syndrome #HRS ... #treatment
Posterior Reversible Encephalopathy Syndrome (PRES) - Treatment
Blood pressure control:
 • Aim for 10-25% BP reduction within
Encephalopathy Syndrome ... (PRES) - Treatment ... Encephalopathy #Syndrome ... #Treatment #Management ... #Neurology
Algorithm for the Treatment of Uremic Pruritus
Nonpharmacologic Treatments:
 • Daily topical emollient
 • Avoidance of extremes
Algorithm for the Treatment ... Nonpharmacologic Treatments ... Limited Effcacy Data ... Uremic #Pruritus #uremia ... #management #nephrology
Aplastic Anemia - Overview

Who?
• M = F
• 3 peaks:	1) Childhood	2) 15-25 years	3) >60 years

What?
• Aplastic anemia
Constitutional Syndromes ... Constitutional Syndromes ... marrow-failure syndromes ... myelodysplastic syndrome ... Treatment: