Hepatorenal Syndrome Diagnosis • ↑ in serum Cr of ≥ 0.3mg/dL above baseline - Type 1 HRS —Two fold rise to >2.5mg/dL within 2 weeks - Type 2 HRS — Rise is either less severe and/or more gradual • Severe liver disease (e.g. advanced cirrhosis, severe alcoholic hepatitis) • Moderate to severe ascites • Volume non-responsive (i.e. giving IV fluids does not significantly improve renal function) Usually Present: • Unremarkable UA (including no proteinuria) • ↓ urine output and/or ↓ diuretic responsiveness (the latter is a hallmark specifically characteristic of type 2 HRS) • Low urine Na+ (<10 mEq/L, FENa < 1%) - Dr. Eric Strong @DrEricStrong - Strong Medicine https://www.youtube.com/c/EricsMedicalLectures/ #Hepatorenal #Syndrome #diagnosis #HRS #nephrology #criteria #types

Pharmacological Treatment of Hepatorenal Syndrome (HRS) Midodrine - Alpha agonist incr blood pressure incr renal perfusion pressure Octreotide - Long-acting analogue of somatostatin decr splanchnic vasodilatation Vasopressin - V1 receptor agonist. Vasoconstriction of systemic and splanchnic circulations Terlipressin - Vasopressin analogue Norepinephrine Alpha, beta-adrenergic agonist. Systemic vasoconstriction Dr. Edgar V. Lerma @edgarvlermamd - Nephrology Secrets https://amzn.to/34t5DgJ #HRS #HepatoRenal #Syndrome #Nephrology #Management #Pharmacology #Medications #Treatment

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