Ascites, Hyponatremia, and Hepatorenal Syndrome: Progress in Treatment
A. L. Gerbes
Karger Medical and Scientific Publishers, 2011 - Medical - 212 pages
At the cutting edge of pathomechanisms and treatment strategies Ascites is the most frequent and hepatorenal syndrome the most lethal complication in liver cirrhosis. In recent years, major progress has been made regarding effective treatment of these complications, thus reducing mortality in patients. This publication highlights and critically appraises recent achievements and novel advances, and at the same time provides the background needed to grasp novel concepts. Topics treated include complications of paracentesis, the right choice of plasma expanders, and selection of patients who will experience survival benefit from transjugular intrahepatic portosystemic shunt. Hepatorenal syndrome, on the other hand, is responsible for a broad spectrum of manifestations caused by acute kidney injury, which until recently was considered a lethal condition. Drug treatments to improve renal function and prolong survival are therefore also discussed, including important issues for clinical outcome which are still under debate. Moreover, the role of combined kidney-liver transplantation versus conventional liver-only transplantation is addressed, as well as the use of vaptans in hyponatremia and their controversial role in the treatment of ascites. Renowned experts share their knowledge and expertise and provide an international perspective. Their contributions include up-to-date references and a bullet-point summary, making this publication most valuable for practitioners, clinicians and scientists in the field.
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Role of Infections in Hepatorenal Syndrome
TIPS for HRS
Vasoconstrictor Therapy for HepatorenalSyndrome
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abdominal advanced cirrhosis adverse events albumin infusion aldosterone antibiotic Arroyo arterial ascitic fluid bacterial infections bacterial translocation baseline bilirubin bleeding cardiac output cirrhotic patients Clin complications controlled trial decrease diagnosis diuretics dose factors Garcia-Tsao Gastroenterology Gerbes Gines Guevara hemodynamic hepatic encephalopathy Hepatology hepatorenal syndrome hyponatremia hypovolemia improvement increased intrahepatic portosystemic shunt intravenous albumin Karger liver disease liver transplantation MELD score mg/dl midodrine mortality Navasa noradrenaline norfloxacin octreotide ornipressin paracentesis patients treated patients with ascites patients with cirrhosis patients with HRS patients with type PICD placebo plasma portal hypertension portosystemic shunt predictors pressure prognosis protein receptor reduced refractory ascites renal dysfunction renal failure renal function response risk satavaptan serum creatinine serum sodium side effects splanchnic spontaneous bacterial peritonitis survival systemic terlipressin terlipressin and albumin therapeutic therapy tion TIPS tolvaptan transjugular intrahepatic portosystemic treatment type 1 hepatorenal type 1 HRS vaptans vasoconstrictors vasodilation vasopressin Wong F