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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 ... Management Algorithm ... #Syndrome #HRS ... #nephrology
HepatoRenal Syndrome - Pathophysiology

Dr. Edgar V. Lerma @edgarvlermamd - Nephrology Secrets https://amzn.to/34t5DgJ

#HRS #HepatoRenal #Syndrome #Pathophysiology #Diagnosis
HepatoRenal Syndrome ... 34t5DgJ #HRS #HepatoRenal ... #Syndrome #Pathophysiology ... #Diagnosis #Nephrology ... #AKI
Pharmacological Treatment of Hepatorenal Syndrome (HRS)

Midodrine - Alpha agonist incr blood pressure incr renal perfusion pressure
Pharmacological Treatment of Hepatorenal ... Syndrome (HRS) ... 34t5DgJ #HRS #HepatoRenal ... #Syndrome #Nephrology ... #Management #Pharmacology
Acute Kidney Injury - Classification
Prerenal:
 • Dehydration
 • Heart failure (a.k.a. cardiorenal syndrome)
 • Liver failure
a.k.a. cardiorenal syndrome ... failure (a.k.a. hepatorenal ... syndrome) Intrarenal ... prolonged prerenal AKI ... EricsMedicalLectures/ #AKI
Hepatorenal Syndrome Treatment
Volume expansion: 
 • Albumin (typical dose = 1g/kg on day 1 +/- day
Hepatorenal Syndrome ... EricsMedicalLectures/ #Hepatorenal ... #Syndrome #Treatment ... #management #HRS ... #nephrology
Common causes of Acute Kidney Injury AKI - Differential Diagnosis
HEMODYNAMIC
 • Cardiac failure: Impaired forward flow,
Kidney Injury AKI ... calcineurin inhibitors, hepatorenal ... syndrome) • Vascular ... Koratala @NephroP #AKI ... Differential #Diagnosis #nephrology
Causes of Acute Kidney Injury (AKI) - Differential Diagnosis Algorithm
Acute Kidney Injury (AKI) - Acute increase
Kidney Injury (AKI ... Kidney Injury (AKI ... Hypoperfusion • Hepatorenal ... syndromes • Drugs ... #KidneyInjury #Nephrology
Hepatorenal Syndrome - Diagnosis and Management Summary
Who gets HRS?
 • Decompensated cirrhosis
 • Typically with existing
Hepatorenal Syndrome ... Diagnosis and Management ... treatment in HRS-AKI ... #Syndrome #HRS ... #Diagnosis #Management
Posterior Reversible Encephalopathy Syndrome (PRES) - Treatment
Blood pressure control:
 • Aim for 10-25% BP reduction within
Posterior Reversible ... Encephalopathy Syndrome ... Encephalopathy #Syndrome ... #Treatment #Management ... #Neurology
Acute Kidney Injury (AKI) - Management Principles
Prerenal - Correct hemodynamic derangements:
 • If low preload →
Kidney Injury (AKI ... ) - Management Principles ... - inotropes • Hepatorenal ... syndrome → Treat ... EricsMedicalLectures/ #AKI