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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 ... #Hepatorenal #Syndrome ... #Algorithm #nephrology
 End Stage Liver Disease (Cirrhosis) - Complications 
 • Ascites
 • Esophageal Varices
 • Hepatic
Liver Disease (Cirrhosis ... (HPS) • Hepatorenal ... Syndrom (HRS) ... Complications #diagnosis ... #management #summary
Approach to the Hospitalized Patient with Cirrhosis
1) Recognize and Manage Decompensation
 • Ascites
 • Variceal Bleeding
Hospitalized Patient with Cirrhosis ... Alcoholic Hepatitis • Hepatorenal ... Syndrome • Prognostication ... #diagnosis #treatment ... #management
Hepatorenal Syndrome Diagnosis
 • ↑ in serum Cr of ≥ 0.3mg/dL above baseline
Hepatorenal Syndrome ... Diagnosis • ↑ ... (e.g. advanced cirrhosis ... #Syndrome #diagnosis ... #HRS #nephrology
Hepatorenal Syndrome - Diagnosis and Management Summary
Who gets HRS?
 • Decompensated cirrhosis
 • Typically with existing
Hepatorenal Syndrome ... - Diagnosis and ... Management Summary ... Decompensated cirrhosis ... #Diagnosis #Management
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
Diuretics and Agents Regulating Renal Excretion

Carbonic Anhydrase Inhibitors (Acetazolamide, Dichlorphenamide)
 • Glaucoma
 • Epilepsy
 • Altitude
disequilibrium syndrome ... • Diagnosis of ... irrigation • Management ... and nephrotic syndrome ... Excretion #Diuresis #Nephrology
Behçet's Syndrome
Systemic disease associated with inflammation of multiple organs, small-vessel vasculitis and large-vessel vasculopathy
Epidemiology:
 • Young
response to local skin ... injury) • Neurologic ... retinal damage) • Skin ... test (this is a skin ... #diagnosis #management
Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
Definition: 
 • Severe adverse drug reaction, characterized by
Criteria for Diagnosis ... Skin involvement ... SinaiBmoreIMRes #DRESS #Syndrome ... #dermatology #diagnosis ... #management
Capnocytophaga Canimorsus Skin Rash

40 M presents w/ N, V, severe epigastric pain. SHx: smoker, drinks 18
Capnocytophaga Canimorsus Skin ... asplenia, alcoholism, cirrhosis ... the key to the diagnosis ... #Rash #dermatology ... #clinical #photo