Hepatorenal Syndrome: Definitions, Diagnosis, and Management

Sebastiano Buccheri; Ben L Da

doi:10.1016/j.cld.2022.01.002

Hepatorenal Syndrome: Definitions, Diagnosis, and Management

Clin Liver Dis. 2022 May;26(2):181-201. doi: 10.1016/j.cld.2022.01.002. Epub 2022 Apr 1.

Authors

Sebastiano Buccheri¹, Ben L Da²

Affiliations

¹ Department of Internal Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, 400 Community Drive, Manhasset, NY 11030, USA.
² Department of Internal Medicine, Division of Hepatology, Sandra Atlas Bass Center for Liver Diseases & Transplantation, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, 400 Community Drive, Manhasset, NY 11030, USA. Electronic address: bda@northwell.edu.

PMID: 35487604
DOI: 10.1016/j.cld.2022.01.002

Abstract

Hepatorenal syndrome (HRS) is a hemodynamically driven process mediated by renal dysregulation and inflammatory response. Albumin, antibiotics, and β-blockers are among therapies that have been studied in HRS prevention. There are no Food and Drug Administration-approved treatments for HRS although multiple liver societies have recommended terlipressin as first-line pharmacotherapy. Renal replacement therapy is the primary modality used to bridge to definitive therapy with orthotopic liver transplant or simultaneous liver-kidney transplant. Advances in our understanding of HRS pathophysiology and emerging therapeutic modalities are needed to change outcomes for this vulnerable population.

Keywords: Hepatorenal syndrome; Liver transplantation; Norepinephrine; Octreotide; Terlipressin.

Publication types

Review

MeSH terms

Albumins / therapeutic use
Female
Hepatorenal Syndrome* / diagnosis
Hepatorenal Syndrome* / etiology
Hepatorenal Syndrome* / therapy
Humans
Kidney Transplantation*
Liver Transplantation*
Male
Terlipressin / therapeutic use

Substances

Albumins
Terlipressin