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Abstract Details
Renal dysfunctions and liver disease: a brief update on management with particular attention to hepatorenal syndrome
Monica Surace1, Immacolata Andria2, Giovanni Valentini3
Author information
1Gastroenterology Unit, Rivoli Hospital, Rivoli, Turin, Italy - surmon@hotmail.com.
2Emergency Department, Maria Vittoria Hospital, Turin, Italy.
3Gastroenterology Unit, Rivoli Hospital, Rivoli, Turin, Italy.
Abstract
In 2015 the International Club of Ascites gave an accurate, exact and new definition of acute renal injury in cirrhotic patient, identifying objective criteria of severity and recoding Hepatorenal Syndrome as a particular form of renal dysfunction for which excessive renal vasoconstriction is one of the main, but not the only, pathophysiological mechanisms. In this review we have tried to outline new pathophysiological and therapeutic insights and to summarize the most recent recommendations. Vasopressor such as terlipressin and norepinephrine, in combination with albumin, still represent the first line therapy, but the new discoveries in the pathophysiology of the disease have led the search for to new pharmacological approaches, although, to date, the only definitive remedy is represented by liver (or simultaneous liver-kidney) transplantation.