Le syndrome hépatorénal chez le patient cirrhotique [Hepatorenal syndrome in patients with liver cirrhosis].

Détails

ID Serval
serval:BIB_2975F81206C9
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Le syndrome hépatorénal chez le patient cirrhotique [Hepatorenal syndrome in patients with liver cirrhosis].
Périodique
Néphrologie and Thérapeutique
Auteur⸱e⸱s
Zaza S., Bonny O., Liaudet L.
ISSN
1769-7255 (Print)
ISSN-L
1769-7255
Statut éditorial
Publié
Date de publication
2005
Volume
1
Numéro
3
Pages
174-182
Langue
français
Notes
Publication types: English Abstract ; Journal Article ; Review
Publication Status: ppublish
Résumé
Hepatorenal syndrome is a particular form of functional renal failure which may develop in patients with liver cirrhosis. On a clinical standpoint, precise diagnostic criteria have been established to clearly define this entity, whereas recent advances in the understanding of the biology of vasoactive mediators and the physiology of microcirculation have allowed to better anticipate its pathophysiological mechanisms. During the course of cirrhosis, sinusoidal portal hypertension leads to splanchnic and systemic vasodilation, responsible for a reduction of effective arterial blood volume. As a result, a state of intense renal vasoconstriction develops, leading to renal failure in the absence of any organic renal disease. At this stage, liver transplantation is the only definitive therapy able to reverse renal dysfunction. In recent years, innovative therapies have shown promise to prolong survival in patients with hepatorenal syndrome, including the administration of analogs of vasopressin (mainly terlipressin), the insertion of transjugular intrahepatic portosystemic shunts and the use of novel techniques of dialysis. On a preventive viewpoint, several simple measures have been shown to reduce the risk of hepatorenal syndrome in cirrhotic patients, including the appropriate use of diuretics, the avoidance of nephrotoxic drugs, the prophylaxis of spontaneous bacterial peritonitis and optimal fluid management in patients undergoing large volume paracentesis.
Mots-clé
Hepatorenal Syndrome/complications, Hepatorenal Syndrome/diagnosis, Humans, Liver Cirrhosis/complications
Pubmed
Création de la notice
24/01/2008 17:01
Dernière modification de la notice
20/08/2019 13:09
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