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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 ... amzn.to/34t5DgJ #HRS ... #Pathophysiology ... #AKI
Acute Kidney Injury (AKI) - Differential Diagnosis Framework
Pre-Renal:
 • Hypovolemia, Cardiorenal, Distributive Shock, HRS, Hypercalcemia, Renal
Kidney Injury (AKI ... Distributive Shock, HRS ... Abdominal Compartment Syndrome ... Differential #Diagnosis #nephrology ... #causes #algorithm
Acute Kidney Injury - Classification
Prerenal:
 • Dehydration
 • Heart failure (a.k.a. cardiorenal syndrome)
 • Liver failure
a.k.a. cardiorenal syndrome ... vasculitis - TTP/HUS ... tubular necrosis (causes ... tract infection • Medications ... Classification #diagnosis #nephrology
Pharmacological Treatment of Hepatorenal Syndrome (HRS)

Midodrine - Alpha agonist incr blood pressure incr renal perfusion pressure
Pharmacological Treatment ... of Hepatorenal Syndrome ... (HRS) Midodrine ... #Pharmacology #Medications ... #Treatment
Causes of Acute Kidney Injury (AKI) - Differential Diagnosis Algorithm
Acute Kidney Injury (AKI) - Acute increase
Causes of Acute ... • Hepatorenal syndromes ... Ethylene glycol) TTP/HUS ... #KidneyInjury #Nephrology ... Diagnosis #Algorithm #Causes
Acute Kidney Injury - AKI Workup Algorithm and Differential Diagnosis
Baseline Investigations: full blood count with differential,
osmolarity If cause ... pressure • TTP / HUS ... • Cardio-renal syndrome ... Differential #Diagnosis #nephrology ... #causes
Hepatorenal Syndrome - Diagnosis and Management Summary
Who gets HRS?
 • Decompensated cirrhosis
 • Typically with existing
Hepatorenal Syndrome ... a precipitant: Medications ... in HRS-AKI is vasoactive ... #Hepatorenal #Syndrome ... #Management #treatment
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
Rhabdomyolysis - Differential Diagnosis Framework and Management Summary

Causes of Rhabdomyolysis:
 • Trauma:
	- Immobilization
	- Crush injury
	- Compartment
Management Summary Causes ... declines > ALT) • AKI ... + myoglobin AKI ... output: 200 ml/hr ... #treatment #nephrology