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AKI in Cirrhosis - Hepatorenal Syndrome Management Algorithm

DOI: 10.1136/bmj.m2687

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

Midodrine - Alpha agonist incr blood pressure incr renal perfusion pressure
Syndrome (HRS) ... pressure incr renal ... #HepatoRenal #Syndrome ... #Nephrology #Management ... #Pharmacology #Medications
Hepatorenal Syndrome Diagnosis
 • ↑ in serum Cr of ≥ 0.3mg/dL above baseline
Hepatorenal Syndrome ... (e.g. advanced cirrhosis ... significantly improve renal ... #Syndrome #diagnosis ... #HRS #nephrology
Hepatorenal Syndrome - Diagnosis and Management Summary
Who gets HRS?
 • Decompensated cirrhosis
 • Typically with existing
Hepatorenal Syndrome ... Diagnosis and Management ... Decompensated cirrhosis ... a precipitant: Medications ... #Syndrome #HRS
Continuous Renal Replacement Therapy (CRRT) - Overview
Types of CRRT
 • CVVHD - Continuous Veno-Venous hemodialysis -
Continuous Renal ... Replacement Therapy ... = 20-25 mL/kg/hr ... #Continuous #Renal ... #Nephrology #Management
Diuretics and Agents Regulating Renal Excretion

Carbonic Anhydrase Inhibitors (Acetazolamide, Dichlorphenamide)
 • Glaucoma
 • Epilepsy
 • Altitude
Agents Regulating Renal ... irrigation • Management ... Inhibitors of Renal ... Excretion #Diuresis #Nephrology ... #Pharmacology #Medications
Renal Replacement Therapy (RRT) - ICU One Pager Summary
Indications (AIEOU):
 • A: Acidosis (usually severe metabolic)
Renal Replacement ... Pager Summary Indications ... CRRT (Continuous renal ... #RRT #managment ... #nephrology #CRRT
Hyperkalemia - Diagnosis and Management - GrepMed Handbook

S/Sx: Most pts asymptomatic. Weakness, cramping, nausea, paresthesias, palpitations,
Etiology: • Medications ... delivery): CHF, cirrhosis ... depress, ↑PR ↑QRS ... STOP offending medications ... Treatment #potassium #nephrology
Who to block and who not to block? Guidelines for Emergency Regional Anesthesiafor Trauma Orthopedic Injuries
Block
OK • Shoulder dislocation ... Hip fracture and dislocation ... not delay block placement ... document detailed neurologic ... #Orthopedics #Management