Diagnosis, prevention and treatment of hepatorenal syndrome in cirrhosis

Francesco Salerno, Alexander Gerbes, Pere Ginès, Florence Wong, Vicente Arroyo

Research output: Contribution to journalArticle

663 Citations (Scopus)

Abstract

Hepatorenal syndrome (HRS) is a serious complication of end-stage liver disease, occurring mainly in patients with advanced cirrhosis and ascites, who have marked circulatory dysfunction,1 as well as in patients with acute liver failure.2 In spite of its functional nature, HRS is associated with a poor prognosis,3 4 and the only effective treatment is liver transplantation. During the 56th Meeting of the American Association for the Study of Liver Diseases, the International Ascites Club held a Focused Study Group (FSG) on HRS for the purpose of reporting the results of an international workshop and to reach a consensus on a new definition, criteria for diagnosis and recommendations on HRS treatment. A similar workshop was held in Chicago in 1994 in which standardised nomenclature and diagnostic criteria for refractory ascites and HRS were established.5 The introduction of innovative treatments and improvements in our understanding of the pathogenesis of HRS during the previous decade led to an increasing need to undertake a new consensus meeting. This paper reports the scientific rationale behind the new definitions and recommendations. The international workshop included four issues debated by four panels of experts (see Acknowledgements). The issues were: (1) evidence-based HRS pathogenesis; (2) treatment of HRS using vasoconstrictors; (3) other HRS treatments using transjugular intrahepatic portosystemic stent-shunt (TIPS) and extracorporeal albumin dialysis (ECAD); and (4) new definitions and diagnostic criteria for HRS and recommendations for its treatment.

Original languageEnglish
Pages (from-to)662-670
Number of pages9
JournalPostgraduate Medical Journal
Volume84
Issue number998
DOIs
Publication statusPublished - Dec 2008

Fingerprint

Hepatorenal Syndrome
Fibrosis
Ascites
Therapeutics
Education
Transjugular Intrahepatic Portasystemic Shunt
End Stage Liver Disease
Vasoconstrictor Agents
Terminology
Liver Transplantation
Stents
Renal Dialysis
Albumins

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Diagnosis, prevention and treatment of hepatorenal syndrome in cirrhosis. / Salerno, Francesco; Gerbes, Alexander; Ginès, Pere; Wong, Florence; Arroyo, Vicente.

In: Postgraduate Medical Journal, Vol. 84, No. 998, 12.2008, p. 662-670.

Research output: Contribution to journalArticle

Salerno, F, Gerbes, A, Ginès, P, Wong, F & Arroyo, V 2008, 'Diagnosis, prevention and treatment of hepatorenal syndrome in cirrhosis', Postgraduate Medical Journal, vol. 84, no. 998, pp. 662-670. https://doi.org/10.1136/gut.2006.107789
Salerno, Francesco ; Gerbes, Alexander ; Ginès, Pere ; Wong, Florence ; Arroyo, Vicente. / Diagnosis, prevention and treatment of hepatorenal syndrome in cirrhosis. In: Postgraduate Medical Journal. 2008 ; Vol. 84, No. 998. pp. 662-670.
@article{b92e3e558cb14d2c85173a16a7e4ad24,
title = "Diagnosis, prevention and treatment of hepatorenal syndrome in cirrhosis",
abstract = "Hepatorenal syndrome (HRS) is a serious complication of end-stage liver disease, occurring mainly in patients with advanced cirrhosis and ascites, who have marked circulatory dysfunction,1 as well as in patients with acute liver failure.2 In spite of its functional nature, HRS is associated with a poor prognosis,3 4 and the only effective treatment is liver transplantation. During the 56th Meeting of the American Association for the Study of Liver Diseases, the International Ascites Club held a Focused Study Group (FSG) on HRS for the purpose of reporting the results of an international workshop and to reach a consensus on a new definition, criteria for diagnosis and recommendations on HRS treatment. A similar workshop was held in Chicago in 1994 in which standardised nomenclature and diagnostic criteria for refractory ascites and HRS were established.5 The introduction of innovative treatments and improvements in our understanding of the pathogenesis of HRS during the previous decade led to an increasing need to undertake a new consensus meeting. This paper reports the scientific rationale behind the new definitions and recommendations. The international workshop included four issues debated by four panels of experts (see Acknowledgements). The issues were: (1) evidence-based HRS pathogenesis; (2) treatment of HRS using vasoconstrictors; (3) other HRS treatments using transjugular intrahepatic portosystemic stent-shunt (TIPS) and extracorporeal albumin dialysis (ECAD); and (4) new definitions and diagnostic criteria for HRS and recommendations for its treatment.",
author = "Francesco Salerno and Alexander Gerbes and Pere Gin{\`e}s and Florence Wong and Vicente Arroyo",
year = "2008",
month = "12",
doi = "10.1136/gut.2006.107789",
language = "English",
volume = "84",
pages = "662--670",
journal = "Postgraduate Medical Journal",
issn = "0032-5473",
publisher = "BMJ Publishing Group",
number = "998",

}

TY - JOUR

T1 - Diagnosis, prevention and treatment of hepatorenal syndrome in cirrhosis

AU - Salerno, Francesco

AU - Gerbes, Alexander

AU - Ginès, Pere

AU - Wong, Florence

AU - Arroyo, Vicente

PY - 2008/12

Y1 - 2008/12

N2 - Hepatorenal syndrome (HRS) is a serious complication of end-stage liver disease, occurring mainly in patients with advanced cirrhosis and ascites, who have marked circulatory dysfunction,1 as well as in patients with acute liver failure.2 In spite of its functional nature, HRS is associated with a poor prognosis,3 4 and the only effective treatment is liver transplantation. During the 56th Meeting of the American Association for the Study of Liver Diseases, the International Ascites Club held a Focused Study Group (FSG) on HRS for the purpose of reporting the results of an international workshop and to reach a consensus on a new definition, criteria for diagnosis and recommendations on HRS treatment. A similar workshop was held in Chicago in 1994 in which standardised nomenclature and diagnostic criteria for refractory ascites and HRS were established.5 The introduction of innovative treatments and improvements in our understanding of the pathogenesis of HRS during the previous decade led to an increasing need to undertake a new consensus meeting. This paper reports the scientific rationale behind the new definitions and recommendations. The international workshop included four issues debated by four panels of experts (see Acknowledgements). The issues were: (1) evidence-based HRS pathogenesis; (2) treatment of HRS using vasoconstrictors; (3) other HRS treatments using transjugular intrahepatic portosystemic stent-shunt (TIPS) and extracorporeal albumin dialysis (ECAD); and (4) new definitions and diagnostic criteria for HRS and recommendations for its treatment.

AB - Hepatorenal syndrome (HRS) is a serious complication of end-stage liver disease, occurring mainly in patients with advanced cirrhosis and ascites, who have marked circulatory dysfunction,1 as well as in patients with acute liver failure.2 In spite of its functional nature, HRS is associated with a poor prognosis,3 4 and the only effective treatment is liver transplantation. During the 56th Meeting of the American Association for the Study of Liver Diseases, the International Ascites Club held a Focused Study Group (FSG) on HRS for the purpose of reporting the results of an international workshop and to reach a consensus on a new definition, criteria for diagnosis and recommendations on HRS treatment. A similar workshop was held in Chicago in 1994 in which standardised nomenclature and diagnostic criteria for refractory ascites and HRS were established.5 The introduction of innovative treatments and improvements in our understanding of the pathogenesis of HRS during the previous decade led to an increasing need to undertake a new consensus meeting. This paper reports the scientific rationale behind the new definitions and recommendations. The international workshop included four issues debated by four panels of experts (see Acknowledgements). The issues were: (1) evidence-based HRS pathogenesis; (2) treatment of HRS using vasoconstrictors; (3) other HRS treatments using transjugular intrahepatic portosystemic stent-shunt (TIPS) and extracorporeal albumin dialysis (ECAD); and (4) new definitions and diagnostic criteria for HRS and recommendations for its treatment.

UR - http://www.scopus.com/inward/record.url?scp=61849168547&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=61849168547&partnerID=8YFLogxK

U2 - 10.1136/gut.2006.107789

DO - 10.1136/gut.2006.107789

M3 - Article

C2 - 19201943

AN - SCOPUS:34548120893

VL - 84

SP - 662

EP - 670

JO - Postgraduate Medical Journal

JF - Postgraduate Medical Journal

SN - 0032-5473

IS - 998

ER -