Hepatorenal syndrome

Abstract

Hepatorenal syndrome is a functional and reversible cause of renal failure that can occur in patients with chronic liver disease and portal hypertension; some factors have been related on his etiology like the alteration in the balance of multiple vasoconstrictor or vasodilator endogenous substances that affect the renal vascular bed and systemic circulation. There are pharmacological strategies that can prevent the hepatorenal syndrome before transplantation in alcoholic cirrhosis.  Some clinical studies had evaluated the effectiveness of Pentoxifiline, albumin and noradrenalin, Octreotide or Terlipressin. Although the treatment of election for these patients is the hepatic transplantation, but if the patient is not eligible for transplant there is still an option of a preservative strategy by the use of portosistemic shunts or sequential paracentesis.