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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
 End Stage Liver Disease (Cirrhosis) - Complications 
 • Ascites
 • Esophageal Varices
 • Hepatic
Liver Disease (Cirrhosis ... Hepatopulmonary Syndrome ... (HPS) • Hepatorenal ... Syndrom (HRS) ... Complications #diagnosis #management
Pharmacological Treatment of Hepatorenal Syndrome (HRS)

Midodrine - Alpha agonist incr blood pressure incr renal perfusion pressure
Pharmacological Treatment of Hepatorenal ... Syndrome (HRS) ... amzn.to/34t5DgJ #HRS ... #HepatoRenal #Syndrome ... #Nephrology #Management
Hepatorenal Syndrome Diagnosis
 • ↑ in serum Cr of ≥ 0.3mg/dL above baseline
Hepatorenal Syndrome ... (e.g. advanced cirrhosis ... EricsMedicalLectures/ #Hepatorenal ... #Syndrome #diagnosis ... #HRS #nephrology
Hepatorenal Syndrome Treatment
Volume expansion: 
 • Albumin (typical dose = 1g/kg on day 1 +/- day
Hepatorenal Syndrome ... EricsMedicalLectures/ #Hepatorenal ... #Syndrome #Treatment ... #management #HRS ... #nephrology
Hepatorenal Syndrome - Diagnosis and Management Summary
Who gets HRS?
 • Decompensated cirrhosis
 • Typically with existing
Hepatorenal Syndrome ... Diagnosis and Management ... Decompensated cirrhosis ... #Syndrome #HRS ... #Diagnosis #Management
Management of SIADH
Treat underlying cause:
 • Causes can include pain, primary lung pathology, post-operative phenomenon, medications,
Management of SIADH ... Contraindicated in cirrhosis ... ADH receptor • Has ... SatyaPatelMD #SIADH ... #nephrology #treatment
SIADH Treatment Options
1. Treat underlying cause of SIADH: Pain, Primary lung pathology, Post-operative phenomenon, Medications, Basically
SIADH Treatment ... restriction • All food has ... Contraindicated in cirrhosis ... #Management #hyponatremia ... #nephrology #treatment
VIBES Mnemonic - Cirrhosis Management Checklist

V - Volume (Ascites, HRS)
	- Evaluate for Ascites, Edema, Hydrothorax, Hepatorenal
VIBES Mnemonic - Cirrhosis ... Management Checklist ... Volume (Ascites, HRS ... , Hydrothorax, Hepatorenal ... Syndrome - Tx
Hepatorenal Syndrome (HRS)

Definition:
• Functional, potentially reversible kidney impairment.
• Occurs in advanced liver disease: cirrhosis, severe alcoholic
Hepatorenal Syndrome ... liver disease: cirrhosis ... #HRS #Hepatorenal ... #Syndrome #Hepatology ... #Nephrology #Diagnosis