What is hepatorenal syndrome in cirrhosis?

Updated: Jul 30, 2018
  • Author: David C Wolf, MD, FACP, FACG, AGAF, FAASLD; Chief Editor: BS Anand, MD  more...
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This syndrome represents a continuum of renal dysfunction that may be observed in patients with a combination of cirrhosis and ascites. Hepatorenal syndrome is caused by the vasoconstriction of large and small renal arteries and the impaired renal perfusion that results. [32]

The syndrome may represent an imbalance between renal vasoconstrictors and vasodilators. Plasma levels of a number of vasoconstricting substances—including angiotensin, antidiuretic hormone, and norepinephrine—are elevated in patients with cirrhosis. Renal perfusion appears to be protected by vasodilators, including prostaglandins E2 and I2 and atrial natriuretic factor.

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