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AKI in Cirrhosis - Hepatorenal Syndrome Management Algorithm

DOI: 10.1136/bmj.m2687

#AKI #Cirrhosis #Hepatorenal #Syndrome #HRS #Management #Algorithm #nephrology
- Hepatorenal Syndrome ... Management Algorithm ... #Hepatorenal #Syndrome ... #HRS #Management ... #Algorithm #nephrology
Pulmonary Renal Syndrome

Definition: Diffuse alveolar hemorrhage + Glomerulonephritis
Presentation (Pulmonary and renal manifestations can occur weeks apart):
Pulmonary Renal Syndrome ... Pulmonary Renal Syndromes ... Systemic lupus erythematosus ... biopsy By Tess Litchman ... differential #diagnosis #nephrology
Pharmacological Treatment of Hepatorenal Syndrome (HRS)

Midodrine - Alpha agonist incr blood pressure incr renal perfusion pressure
of Hepatorenal Syndrome ... (HRS) Midodrine ... amzn.to/34t5DgJ #HRS ... #HepatoRenal #Syndrome ... #Nephrology #Management
Systemic Lupus Erythematosus - Summary
Antinuclear (ANA) - 95% - Initial screening test
Anti-dsDNA - 50%
 • Associated
Systemic Lupus Erythematosus ... block • Sjogren syndrome ... polymyositis overlap syndrome ... Hydroxychloroquine *Short ... #rheumatology #management
Hepatorenal Syndrome Treatment
Volume expansion: 
 • Albumin (typical dose = 1g/kg on day 1 +/- day
Hepatorenal Syndrome ... #Hepatorenal #Syndrome ... #Treatment #management ... #HRS #nephrology
Posterior Reversible Encephalopathy Syndrome (PRES) - Treatment
Blood pressure control:
 • Aim for 10-25% BP reduction within
Encephalopathy Syndrome ... within first 2-6 hrs ... Encephalopathy #Syndrome ... #Treatment #Management ... #Neurology
CNS Manifestations of Systemic Lupus Erythematosus (SLE)

Clinical Manifestations: Demyelinating Syndrome, Headache, Movement disorders, Seizure disorders, Aseptic
Systemic Lupus Erythematosus ... Demyelinating Syndrome ... Systemic #Lupus #Erythematosus ... #SLE #CNS #neurology ... cerebritis #diagnosis #management
Hyponatremia Correction
1. Indications for Hypertonic Saline: seizure, coma, focal findings
   - typically occurs with
correction of 0.5-1 mEq/hr ... Demyelination Syndrome ... Correction #goal #rate #management ... #nephrology
Guillain-Barre Syndrome - Summary

Acute AIDP that presents with rapidly progressive flaccid weakness

Epidemiology:
 • 1-2 cases/100,000 per
Guillain-Barre Syndrome ... • Weakness: Starts ... Miller Fisher Syndrome ... #diagnosis #management ... #treatment #neurology
Pain, Agitation, and Delirium (PAD) in the ICU
Addressing the ICU Triad (PAD) can be accomplished through
Total scores >2 ... the ICU due to short ... Propofol infusion syndrome ... x > 6 hrs) can ... CriticalCare #diagnosis #management