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首页> 外文期刊>Sao Paulo Medical Journal >Hepatorenal syndrome: an update
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Hepatorenal syndrome: an update

机译：肝肾综合征：最新情况

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Hepatorenal syndrome (HRS) is the development of renal failure in patients with chronic previous liver disease, without clinical or laboratory evidence of previous kidney disease. It affects up to 18% of cirrhotic patients with ascites during the first year of follow-up, reaching 39% in five years and presenting a survival of about two weeks after its establishment. HRS diagnosis is based on clinical and laboratory data. The occurrence of this syndrome is related to the mechanism for ascites development, involving vasoconstriction, low renal perfusion, water and sodium retention, increased plasma volume, and consequent overflow at the splanchnic level. Renal vasoactive mediators like endothelin 1, thromboxane A2, and leukotrienes are also involved in the genesis of this syndrome, which culminates in functional renal insufficiency. The treatment of choice can be pharmacological or surgical, although liver transplantation is the only permanent and effective treatment, with a four-year survival rate of up to 60%. Liver function recovery is usually followed by renal failure reversion. Early diagnosis and timely therapeutics can increase life expectancy for these patients while they are waiting for liver transplantation as a definitive treatment.
机译：肝肾综合征（HRS）是患有慢性先前肝病的患者发生肾衰竭的症状，而没有先前肾病的临床或实验室证据。在随访的第一年中，它会影响多达18％的肝硬化腹水患者，在五年内达到39％，并在其建立后存活约两周。 HRS诊断基于临床和实验室数据。该综合征的发生与腹水发展的机制有关，包括血管收缩，低肾灌注，水和钠retention留，血浆量增加以及随之而来的内脏水肿。肾血管活性介质（如内皮素1，血栓烷A2和白三烯）也参与该综合征的发生，最终导致功能性肾功能不全。尽管肝移植是唯一永久有效的治疗方法，但四年的生存率高达60％，可以选择药物治疗或外科治疗。肝功能恢复通常是肾衰竭恢复。对于这些等待肝移植的患者，尽早诊断和及时采取治疗措施可以延长他们的预期寿命。

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