Hepatorrenal syndrome in acute on chronic hepatic failure: about a case
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Cirrhosis, Hepatic failure, Hepatic encephalopathy, Hepatorenal syndrome, Liver transplantation.

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Giraldo Ocampo CC, Jiménez Bejarano MF, Torres Saltarin JJ. Hepatorrenal syndrome in acute on chronic hepatic failure: about a case. Rev. Colomb. Nefrol. [Internet]. 2021 Mar. 23 [cited 2022 Aug. 11];8(2):e532. Available from: https://revistanefrologia.org/index.php/rcn/article/view/532


Acute-on-chronic liver failure (ACLF) is a recently characterized entity and presents as an acute decompensation of chronic liver disease, it can be associated with failure in different organs and present high mortality. Its incidence reaches up to 30% of patients who consult for complications in base cirrhosis.

Among the most frequent precipitating factors are bacterial infections, alcoholism and reactivation of viral hepatitis, but, in up to 40% of cases, no precipitating factor is identified. The pathophysiology of this entity is still unknown to a certain extent, but the existence of an excessive inflammatory response in its development is suggested.

There is no specific treatment and its management is based on treatment for associated complications, support, and finally liver transplantation.

Kidney dysfunction is a common finding in patients with liver disease. Hepatorenal syndrome, which was thought to be purely functional in nature and now, given the evidence of some degree of related tubular damage, the understanding of the pathophysiology of this entity has improved and has recently forced a rethink of the diagnostic criteria and the classification of the illness.

We describe the clinical case of a patient treated at a hospital in the city of Pereira, Risaralda. who presented bacteremia due to gram-positive cocci, of unclear origin, this was considered as the precipitating factor, had clinical deterioration, with the appearance of hepatorenal syndrome and multi-organ failure, finally leading to death despite multidisciplinary management.

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