[Hepatorenal Syndrome].

Jun Cheol Choi, Jeong-Ju Yoo
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Abstract

Hepatorenal syndrome (HRS) is a critical and potentially life-threatening complication of advanced liver disease, including cirrhosis. It is characterized by the development of renal dysfunction in the absence of underlying structural kidney pathology. The pathophysiology of HRS involves complex interactions between systemic and renal hemodynamics, neurohormonal imbalances, and the intricate role of vasoconstrictor substances. Understanding these mechanisms is crucial for the timely identification and management of HRS. The diagnosis of HRS is primarily clinical and relies on specific criteria that consider the exclusion of other causes of renal dysfunction. The management of HRS comprises two main approaches: vasoconstrictor therapy and albumin infusion, which aim to improve renal perfusion and mitigate the hyperdynamic circulation often seen in advanced liver disease. Additionally, strategies such as liver transplantation and renal replacement therapy are essential considerations based on individual patient characteristics and disease severity. This review article provides a comprehensive overview of hepatorenal syndrome, focusing on its pathophysiology, diagnostic criteria, and current management strategies.

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[肝肾综合征]。
肝肾综合征(HRS)是晚期肝病(包括肝硬化)的一种严重且可能危及生命的并发症。它的特点是在没有潜在的结构性肾脏病理的情况下发展为肾功能障碍。HRS的病理生理学涉及系统和肾脏血流动力学、神经激素失衡以及血管收缩物质的复杂作用。了解这些机制对于及时识别和管理HRS至关重要。HRS的诊断主要是临床诊断,并依赖于排除其他肾功能障碍原因的特定标准。HRS的治疗包括两种主要方法:血管收缩剂治疗和白蛋白输注,目的是改善肾脏灌注和减轻晚期肝病中常见的高动力循环。此外,肝移植和肾脏替代疗法等策略是基于个体患者特征和疾病严重程度的基本考虑因素。这篇综述文章提供了肝肾综合征的全面概述,重点是其病理生理学,诊断标准和当前的管理策略。
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