HEPATORENAL SYNDROME. DIFFERENTIATED APPROACH TO TREATMENT

Authors

  • Elina Manzhalii Bogomolets National Medical University, PhD, docent

DOI:

https://doi.org/10.37321/nefrology.2021.29-02

Keywords:

hepatorenal syndrome, treatment, pathogenesis, acute liver failure, decompensated liver cirrhosis

Abstract

Introduction. The choice of treatment tactics and the study of the pathogenesis of HRS as a pathological condition of the disease is important to prevent the development of complications in all body systems. After all, HRS as a syndrome manifests itself as a direct lesion on the excretory system, in particular on the kidneys, and with a further risk of developing renal failure. Patients with chronic liver diseases are especially sensitive to the occurrence of HRS.
Goal. Analyze the causal relationship of the occurrence and development of HRS and generalize the treatment strategy based on evidence-based medicine.
Materials and methods. Bibliographic – a theoretical analysis is carried out and a generalization of literature data is carried out. Description and analysis were used in the research.
Results and its discussion. Scientists differentiate the main criteria for GDS as follows. Serum creatinine levels greater than 133 μmol / L; there is no decrease in serum creatinine levels below 133 μmol / l after a twoday discontinuation of diuretics against the background of albumin infusion therapy (the recommended dose of albumin is 1 g / kg of body weight per day to a maximum of 100 g / day); the absence of other reasons for the development of renal failure: shock, sepsis, multiple organ failure, hypovolemia due to extrarenal losses, the use of nephrotoxic agents; absence of parenchymal kidney diseases, manifested by proteinuria more than 500 mg / day, microhematuria (more than 50 erythrocytes in the field of view) and / or changes in the structure and vascular architectonics of the kidneys on ultrasound; the presence of CB with ascites [12].
Conclusions. Monitoring the patient’s indicators, prescribing treatment tactics depending on the type of HRS makes it possible to stabilize the patient’s condition.

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Published

2021-12-14

How to Cite

Manzhalii Е. (2021). HEPATORENAL SYNDROME. DIFFERENTIATED APPROACH TO TREATMENT. Actual Problems of Nephrology, (29), 21–28. https://doi.org/10.37321/nefrology.2021.29-02