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Öz

Hepatorenal syndrome (HRS) is functional renal failure that occurs with advanced liver failure. HRS is considered the most severe complication of cirrhosis. Type 1 HRS develops due to severe reduction of effective circulating volume results in hemodynamic dysfunction. Type 1 HRS is characterized by acute renal failure and rapid deterioration in the function of other organs. It can occur spontaneously or in the setting of a precipitating event. Type 2 hepatorenal syndrome (HRS), which is characterized by slowly progressive renal failure and refractory ascites. Liver transplantation is the only definitive treatment for both types. The most suitable “bridge treatments” or treatment for patients ineligible for a liver transplant include terlipressin plus albumin.

Anahtar Kelimeler

• Hepatorenal Syndrome, renal failure, cirrhosis

Hepatorenal Sendrom (HRS)

Öz

Kronik karaciğer hastalığı zemininde ortaya çıkan morfolojik olarak böbreklerin sağlam olduğu ancak fonksiyonel böbrek yetmezliği tablosu hepatorenal sendrom (HRS) olarak tanımlanır. HRS kötü prognozu nedeniyle sirozun en korkulan komplikasyonudur.

Kronik karaciğer hastalığı zemininde efektif arteriyel kan hacminde azalma ağır hemodinamik değişikliklerle sonuçlanır. Tip 1 HRS aniden gelişen akut böbrek yetmezliği ve diğer organ sistem fonksiyon bozuklukları ile birliktedir. Tip 1 HRS spontan şekilde gelişebilmesine karşın diğer tetikleyici nedenler sonucunda da gelişebilmektedir. Tip 2 HRS siroz ve portal hipertansiyon nedeniyle böbrek fonksiyonlarında yavaş ve ilerleyici azalma ile karakterizedir ve refrakter asit söz konusudur. Karaciğer nakli her iki tip HRS içinde kesin tedavidir. Karaciğer nakli yapılana kadar veya nakil yapılmaya uygun olmayan hastalar için en uygun köprü tedavi terlipresin ve albumin kombinasyonudur.

Anahtar Kelimeler

• Hepatorenal sendrom; böbrek yetmezliği; siroz

Kaynakça

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