Ascites, Hyponatremia, and Hepatorenal Syndrome: Progress in Treatment

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A. L. Gerbes
Karger Medical and Scientific Publishers, 2011 - Medical - 212 pages
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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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Contents

Differential Diagnosis of Ascites
1
Diuretics
11
Paracentesis
23
Which PlasmaExpander?
32
Not Just a Plasma Expander
40
Which Patients WillBenefit?
52
Spontaneous Bacterial Peritonitis Prophylaxis and Treatment
65
Clinical Implications of Hyponatremia inCirrhosis
83
Role of Infections in Hepatorenal Syndrome
130
TIPS for HRS
142
Vasoconstrictor Therapy for HepatorenalSyndrome
149
The US Experience
163
Predictors of Response
172
Safety of Terlipressin for HepatorenalSyndrome
178
Novel Strategies and Future Perspectives
189
Hepatorenal Syndrome and LiverTransplantation
198

Vaptans for Ascites Chances and Risks
91
Cardiorenal Syndrome A New Entity?
102
Renal Failure in Cirrhosis
112
Clinical Consequences
122

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