Hepatorenal syndrome (HRS) is kidney impairment in decompensated liver disease due to decreased renal perfusion that is secondary to severe splanchnic vasodilatation in the absence o...
Cirrhosis with ascites
Increase in serum Cr of 0.3 mg/dl or more within 48 hours; or a 50% or more increase in baseline creatinine over seven days or urine volume <0.5 ...
Abstinence from alcohol
Effective antiviral therapy
Discontinue diuretics.
Av...
Monitor renal and hepatic function and serum electrolytes.
Ambulatory follow-up with hepatology and nephrology
Singh V, Ghosh S, Singh B, et al. Noradrenaline vs. terlipressin in the treatment of hepatorenal syndrome: a randomized study. J Hepatol. ...
Cirrhosis of the Liver; Hepatitis A; Hepatitis B; Hepatitis C
Algorithms: Acetaminophen Poisoning, Treatment; Acute Kidney Injury (Acute Renal Failure)
HRS is a diagnosis of exclusion associated with high mortality
Decompensated cirrhosis with ascites and hyponatremia are common in patients with HRS. Outcomes are linked to reversal of ...
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Graft for hemodialysis angio access - A self-sealing polytetrafluoroethylene (PTFE) silicone graft is used as an internal bridge (AV fistula) for vascular access in patients requiring maintenance hemodialysis. In the figure the graft bridges the brachial artery to the axillary vein
Graft for hemodialysis angio access - A self-sealing polytetrafluoroethylene (PTFE) silicone graft is used as an internal bridge (AV fistu...
Hemidialysis
Chronic hepatitis with cirrhosis. A photomicrograph of the liver from a patient with long-standing chronic active hepatitis B shows hepatocellular nodules and chronically inflamed fibrous septa.
Chronic hepatitis with cirrhosis. A photomicrograph of the liver from a patient with long-standing chronic active hepatitis B shows hepato...
FIGURE 3-2. Peritoneal dialysis, in which the dialysate is infused into the peritoneal cavity by gravity. (Reprinted with permission from Rosdahl, Kowalski. Textbook of Basic Nursing. 8th Ed. Philadelphia: Lippincott Williams & Wilkins, 2003:1208.)
FIGURE 3-2. Peritoneal dialysis, in which the dialysate is infused into the peritoneal cavity by gravity. (Reprinted with permission from...
Fig 13-7. Peritoneal dialysis. A semipermeable membrane richly supplied with small blood vessels lines the peritoneal cavity. With dialysate dwelling in the peritoneal cavity, waste products diffuse from the network of blood vessels into the dialysate.
Fig 13-7. Peritoneal dialysis. A semipermeable membrane richly supplied with small blood vessels lines the peritoneal cavity. With dialysa...
Hemodialysis.
Hemodialysis, external arteriovenous shunt. Illustration of the medial side of the right arm with an external arteriovenous shunt uses in hemodialysis.
Hemodialysis, external arteriovenous shunt. Illustration of the medial side of the right arm with an external arteriovenous shunt uses in ...
Hemodialysis, internal arteriovenous fistula. Illustration of the medial side of the right arm with an internal arteriovenous fistula used in hemodialysis.
Hemodialysis, internal arteriovenous fistula. Illustration of the medial side of the right arm with an internal arteriovenous fistula used...
Continuous ambulatory peritoneal dialysis: Step 1 After applying a mask, a bag of dialysate is attached to the tube entering the patient's abdominal area so that the fluid flows into the peritoneal cavity. The mask is removed when this step is completed.
Continuous ambulatory peritoneal dialysis: Step 1 After applying a mask, a bag of dialysate is attached to the tube entering the patient's ...
Alcoholic cirrhosis. The surface of the liver displays innumerable small, regular nodules.
Alcoholic cirrhosis. A photomicrograph shows small regular nodules surrounded by uniform fibrous septa.
Cirrhosis of the liver. The consequence of chronic hepatic injury is the formation of regenerating nodules separated by bands of fibrous connective tissue (blue).
Cirrhosis of the liver. The consequence of chronic hepatic injury is the formation of regenerating nodules separated by bands of fibrous co...