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HepatoRenal Syndrome - Pathophysiology

Dr. Edgar V. Lerma @edgarvlermamd - Nephrology Secrets https://amzn.to/34t5DgJ

#HRS #HepatoRenal #Syndrome #Pathophysiology #Diagnosis
HepatoRenal Syndrome ... - Pathophysiology ... edgarvlermamd - Nephrology ... #Syndrome #Pathophysiology ... #AKI
Pharmacological Treatment of Hepatorenal Syndrome (HRS)

Midodrine - Alpha agonist incr blood pressure incr renal perfusion pressure
Pharmacological Treatment ... of Hepatorenal ... Syndrome (HRS) ... #Syndrome #Nephrology ... #Pharmacology #Medications
Acute Kidney Injury - Classification
Prerenal:
 • Dehydration
 • Heart failure (a.k.a. cardiorenal syndrome)
 • Liver failure
failure (a.k.a. hepatorenal ... syndrome) Intrarenal ... tubular necrosis (causes ... tract infection • Medications ... Classification #diagnosis #nephrology
Acute Kidney Injury (AKI) - Differential Diagnosis Framework
Pre-Renal:
 • Hypovolemia, Cardiorenal, Distributive Shock, HRS, Hypercalcemia, Renal
Kidney Injury (AKI ... Abdominal Compartment Syndrome ... Medicine @SCVMCMed #AKI ... Differential #Diagnosis #nephrology ... #causes #algorithm
Causes of Acute Kidney Injury (AKI) - Differential Diagnosis Algorithm
Acute Kidney Injury (AKI) - Acute increase
Causes of Acute ... Kidney Injury (AKI ... Hypoperfusion • Hepatorenal ... syndromes • Drugs ... #KidneyInjury #Nephrology
Common causes of Acute Kidney Injury AKI - Differential Diagnosis
HEMODYNAMIC
 • Cardiac failure: Impaired forward flow,
Common causes of ... Kidney Injury AKI ... calcineurin inhibitors, hepatorenal ... syndrome) • Vascular ... Differential #Diagnosis #nephrology
Acute Kidney Injury (AKI) - Management Principles
Prerenal - Correct hemodynamic derangements:
 • If low preload →
Kidney Injury (AKI ... - inotropes • Hepatorenal ... syndrome → Treat ... → No specific treatment ... Kidney #Injury #treatment
Hepatorenal Syndrome - Diagnosis and Management Summary
Who gets HRS?
 • Decompensated cirrhosis
 • Typically with existing
Hepatorenal Syndrome ... a precipitant: Medications ... infection Mainstay of treatment ... in HRS-AKI is vasoactive ... #Syndrome #HRS
Leukostasis vs Tumor Lysis Syndrome
Leukostasis:
 • Pathophysiology: Large, immature blasts and high WBC count cause hyperviscosity
Leukostasis: • Pathophysiology ... high WBC count cause ... fever - ACS, AKI ... organ damage • Treatment ... : • Pathophysiology
Summary of Infections in which Steroids play a role in treatment
 • TB meningitis
 • TB
play a role in treatment ... pericarditis (select cases ... pneumonia • COVID ... • Ramsay Hunt syndrome ... #Steroids #Indications