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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
Syndrome (HRS) ... edgarvlermamd - Nephrology ... #Syndrome #Nephrology ... #Management #Pharmacology ... #Medications #Treatment
Hepatorenal Syndrome Treatment
Volume expansion: 
 • Albumin (typical dose = 1g/kg on day 1 +/- day
Hepatorenal Syndrome ... EricsMedicalLectures/ #Hepatorenal ... #Syndrome #Treatment ... #management #HRS ... #nephrology
Indications for Albumin for Management of Cirrhosis
 • Large volume paracentesis (>5 liter) - 8g per
Indications for ... Albumin for Management ... antibiotics • Hepatorenal ... syndrome - 1g/ ... #Management #Cirrhosis
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 ... tract infection • Medications ... Classification #diagnosis #nephrology
Hepatorenal Syndrome - Diagnosis and Management Summary
Who gets HRS?
 • Decompensated cirrhosis
 • Typically with existing
Hepatorenal Syndrome ... Diagnosis and Management ... a precipitant: Medications ... circulatory overload, CV ... #Syndrome #HRS
Hyponatremia Correction
1. Indications for Hypertonic Saline: seizure, coma, focal findings
   - typically occurs with
Indications for ... seizure, coma, focal ... Demyelination Syndrome ... Correction #goal #rate #management ... #nephrology
Stroke Evaluation and Management Algorithm

Clinical suspicion of stroke (BE FAST)
 • Balance loss
 • Eyes: vision
Evaluation and Management ... Klaas #Stroke #Management ... Algorithm #diagnosis #differential ... #neurology #CVA
Stroke - Differential Diagnosis Algorithm and Management
Hemorrhagic:
 • Intracerebral: HTN, Cerebral Amyloid Angiopathy, Trauma, Bleeding Diathesis,
Stroke - Differential ... Algorithm and Management ... SCVMCMed #Stroke #CVA ... #Differential # ... #neurology #treatment
Mydriasis and Miosis - Differential Diagnosis Framework

Causes of Mydriasis:
Dilated pupils (mydriasis) more than 7mm
 • Unilateral
Mydriasis and Miosis - Differential ... response, Serotonin syndrome ... Miosis: Horner's syndrome ... hemorrhage, Pontine CVA ... Mydriasis #Miosis #differential