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World J Gastroenterol. Aug 14, 2007; 13(30): 4046-4055
Published online Aug 14, 2007. doi: 10.3748/wjg.v13.i30.4046
Hepatorenal syndrome
Sharon Turban, Paul J Thuluvath, Mohamed G Atta
Sharon Turban, Mohamed G Atta, Department of Medicine, Division of Nephrology, Johns Hopkins School of Medicine and the Johns Hopkins Hospital, Baltimore, Maryland, United States
Paul J Thuluvath, Department of Medicine, Division of Gastroenterology, Johns Hopkins School of Medicine and the Johns Hopkins Hospital, Baltimore, Maryland, United States
Author contributions: All authors contributed equally to the work.
Correspondence to: Mohamed G Atta, MD, MPH, Johns Hopkins University, Division of Nephrology, 1830 East Monument Street, Suite 416, Baltimore, Maryland-21205, United States. matta1@jhmi.edu
Telephone: +1-410-9555268 Fax: +1-410-9550485
Received: January 11, 2007
Revised: January 25, 2007
Accepted: March 8, 2007
Published online: August 14, 2007
Abstract

Hepatorenal syndrome (HRS) is a “functional” and reversible form of renal failure that occurs in patients with advanced chronic liver disease. The distinctive hallmark feature of HRS is the intense renal vasoconstriction caused by interactions between systemic and portal hemodynamics. This results in activation of vasoconstrictors and suppression of vasodilators in the renal circulation. Epidemiology, pathophysiology, as well as current and emerging therapies of HRS are discussed in this review.

Keywords: Acute renal failure; End stage liver disease; Hepatorenal syndrome; Transjugular intrahepatic portosystemic shunts; Dialysis; Liver transplantation