SCCM Resource Library-Hepatorenal Syndrome: Can the Kidneys Be Saved From the Wrath of the Liver?

Video Transcription

Video Summary

The speaker discusses the effects of liver disease on renal function, specifically focusing on Hepatorenal Syndrome (HRS). HRS is a spectrum of kidney injury in patients with liver disease, ranging from functional to parenchymal damage. HRS is characterized by circulatory dysfunction, microvascular dysfunction, and inflammation. The traditional approach to diagnosing HRS requires excluding underlying kidney damage, but newer concepts suggest incorporating established criteria for acute kidney injury (AKI). There are two types of HRS: type 1, which is rapid and often caused by sepsis or hemorrhage, and type 2, which is slow and occurs in patients with refractory ascites. Treatment for HRS involves close monitoring of renal function, correcting hypovolemia, and avoiding nephrotoxic drugs. Albumin and vasopressors are used if AKI worsens, and although the choice of vasopressor is debated, telepressin appears to be effective but has serious adverse effects such as respiratory failure. The speaker emphasizes the need for further research and the inclusion of urine output criteria in diagnosing and staging HRS.

Asset Subtitle

Renal, GI and Nutrition, 2022

Asset Caption

SCCM's Guidelines for the Management of Adult Acute and Acute-on-Chronic Liver Failure in the ICU were published in March 2020. This session will cover these recommendations and continued controversies surrounding managing these complex patients. The guidelines cover recommendations for cardiovascular, endocrine, hematologic, pulmonary, and renal considerations. This session will cover selected topics, including hemodynamics and resuscitation, coagulopathy, and renal complications.

Meta Tag

Content Type Presentation

Knowledge Area Renal

Knowledge Area GI and Nutrition

Knowledge Level Intermediate

Knowledge Level Advanced

Membership Level Select

Tag Kidney

Tag Liver

Year 2022

Keywords

liver disease

renal function

Hepatorenal Syndrome

circulatory dysfunction

microvascular dysfunction

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