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AKI in Cirrhosis - Hepatorenal Syndrome Management Algorithm

DOI: 10.1136/bmj.m2687

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

Midodrine - Alpha agonist incr blood pressure incr renal perfusion pressure
Pharmacological Treatment of Hepatorenal ... Syndrome (HRS) ... pressure incr renal ... #Syndrome #Nephrology ... #Management #Pharmacology
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
 • ↑ in serum Cr of ≥ 0.3mg/dL above baseline
Hepatorenal Syndrome ... significantly improve renal ... EricsMedicalLectures/ #Hepatorenal ... #Syndrome #diagnosis ... #HRS #nephrology
Common causes of Acute Kidney Injury AKI - Differential Diagnosis
HEMODYNAMIC
 • Cardiac failure: Impaired forward flow,
calcineurin inhibitors, hepatorenal ... syndrome) • Vascular ... thromboembolism, renal ... tumors INTRINSINC RENAL ... Differential #Diagnosis #nephrology
Causes of Hypokalemia - Differential Diagnosis Algorithm
Defining the cause of hypokalemia starts by measuring urinary K
Skin and/or ... gastrointestinal K loss • Renal ... hypokalemia • Renal ... , Gitelman's syndrome ... algorithm #causes #nephrology
Causes of Acute Kidney Injury (AKI) - Differential Diagnosis Algorithm
Acute Kidney Injury (AKI) - Acute increase
at least 50% Renal ... Hypoperfusion • Hepatorenal ... syndromes • Drugs ... Sjögren) Post-Renal ... #KidneyInjury #Nephrology
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
mOsm/kg - Implies renal ... loss): GI loss, Skin ... , Ingestion Renal ... , Cushing syndrome ... Workup #Algorithm #nephrology
Hepatorenal Syndrome (HRS)

Definition:
• Functional, potentially reversible kidney impairment.
• Occurs in advanced liver disease: cirrhosis, severe alcoholic
Hepatorenal Syndrome ... perfusion + ↑ renal ... #HRS #Hepatorenal ... #Syndrome #Hepatology ... #Nephrology #Diagnosis
Hematuria in Post-Renal Transplant Patient
Prevalence up to 12% in the postrenal transplant patient
 • Bacterial: Escherichia
Hematuria in Post-Renal ... (Goodpasture's syndrome ... #Hematuria #Renal ... #blood #urine #management ... #treatment #nephrology