Abstract
Background: Hepatorenal syndrome is a renal dysfunction that occurs in patients with chronic liver disease such as liver cirrhosis or acute liver disease, characterized by the activation of regulatory mechanisms that lead to a decrease in the glomerular filtration rate. Clinically, hepatorenal syndrome is divided into two types, type 1 and type 2. Type 1 is characterized by a rapid and progressive loss of kidney function while type 2 is characterized by slow progression and a better prognosis.
Purpose: To analyze the natural history of the disease presented by patients who develop hepatorenal syndrome.
Methodology: A review of the scientific literature of published manuscripts on hepatorenal syndrome was carried out to evaluate the natural history of this pathology.
Results:There are no specific clinical findings, however, its clinical manifestations reflect the underlying advanced liver disease, kidney failure, and circulatory abnormalities present.
Conclusions: The most appropriate therapeutic option is liver transplantation, but not all patients can receive it, while accessing said management an option is drug treatment with vasoconstrictors and albumin
References
Mindikoglu AL, Pappas SC. New Developments in Hepatorenal Syndrome. Clin Gastroenterol Hepatol. [revista electrónica] 2018 Feb;16(2):162-177. [accedido 22 Agosto 2020]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5831376/
Ospina T J, Restrepo G J. Síndrome hepatorrenal: fisiopatología, diagnóstico y manejo. Rev Col Gastroenterol. [revista electrónica] 31 (2) 2016 [accedido 22 Agosto 2020], Disponible en: http://www.scielo.org.co/scielo.php?script=sci_abstract&pid=S0120-99572016000200007
Francoz C, Durand F, Kahn JA, Genyk YS, Nadim MK. Hepatorenal Syndrome. Clin J Am Soc Nephrol. [revista electrónica] 2019 May 7;14(5):774-781. [accedido 23 Agosto 2020]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6500947/
Nguyen-Tat1 M, Ja¨ger J, Rey JW, Nagel M, Labenz C, Wo¨rns MA, et al. Terlipressin and albumin combination treatment in patients with hepatorenal syndrome type 2. Ueg Journal [revista electrónica] 2019;7(4):529-537 [accedido 23 Agosto 2020]. Disponible en: https://journals.sagepub.com/doi/pdf/10.1177/2050640619825719
de la Vara AA, Vállega MM, Graciano MM, Solera PY. Caso clínico. Paciente con síndrome hepatorrenal tratado con Diálisis Peritoneal. Enferm Nefrol. [revista electrónica] 2017; 20( Suppl 1 ): 69-69. [accedido 26 Agosto 2020] Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2254-28842017000500069&lng=es.
Chmielewski J, Lewandowski J, Maddur H. Hepatorenal Syndrome: Physiology, Diagnosis and Management. Semin Intervent Radiol. [revista electrónica] 2018;35(3):194-197. [accedido 26 Agosto 2020] Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6078701/
Mattos A, Schacher F, Mattos A. Vasoconstrictors in hepatorenal syndrome- A critical review. Annals of Hepatology [revista electrónica] 18 (2019) 287–290 [accedido 27 Agosto 2020]. Disponible en: https://www.sciencedirect.com/science/article/pii/S1665268119300511?via%3Dihub
Sola E, Ginés P. Síndrome hepatorenal. Nefrología al Día [revista electrónica] 2018 [accedido 27 Agosto 2020]. Disponible en: http://www.revistanefrologia.com/es-monografias-nefrologia-dia-articulo-sindrome-hepatorenal-161
Baraldi O, Valentini C, Donati G, Comai G, Cuna V, Capelli I, et al. Hepatorenal syndrome: Update on diagnosis and treatment. World J Nephrol. [revista electrónica] 2015 Nov 6;4(5):511-20. [accedido 27 Agosto 2020]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4635371/
Shah N, Silva R, Kowalski A, Desai C, Lerma E. Hepatorenal syndrome. Dis Mon. [revista electrónica] 2016; 62 (10): 364-375. [accedido 27 Agosto 2020]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27372112/
Low G, Alexander G, Lomas D. Síndrome hepatorrenal: etiología, diagnóstico y tratamiento. Res Pract [revista electrónica] 2015; 2015: 207012. [accedido 27 Agosto 2020] Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306364/pdf/GRP2015-207012.pdf
Runyon B. Hepatorenal syndrome. Uptodate [revista electrónica] 13 de abril de 2020. [accedido 11 sep 2020]. Disponible en: https://www.uptodate.com/contents/hepatorenal-syndrome?search=etiologia%20sindrome%20hepatorrenal&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
Holguín A, Hurtado J, Restrepo J. Una mirada actual a la peritonitis bacteriana espontánea. Rev Col Gastroenterol [revista electrónica] 30 (3) 2015. [accedido 11 sep 2020]. Disponible en: http://www.scielo.org.co/pdf/rcg/v30n3/v30n3a08.pdf
Varela R, Jimenez A, Carillo D, Carillo E, Rodriguez S. Síndrome hepatorenal. Rev medica [revista electrónica] 2015 5(3):134-140pp. [accedido 11 sep 2020]. Disponible en: https://www.medigraphic.com/pdfs/revmed/md-2014/md142h.pdf
Xu L, Liu J, Lu M, Yang D, Zheng X. Liver injury during highly pathogenic human coronavirus infections. Liver International [revista electrónica]. 2020;40:998–1004. [accedido 11 sep 2020]. Disponible en: https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.14435
McCormick, P. Aiden, Jalan R. Hepatic cirrhosis. Sherlock's Diseases of the Liver and Biliary System [revista electrónica] (2018): 107-126. [accedido 11 sep 2020]. Disponible en: https://onlinelibrary.wiley.com/doi/abs/10.1002/9781119237662.ch8
D'Amico G, Morabito A, D'Amico M, Pasta L, Malizia G, Rebora P, et al. Clinical states of cirrhosis and competing risks. Journal of hepatology [revista electrónica]. 2018, vol. 68, no 3, p. 563-576. [accedido 11 sep 2020]. Disponible en: https://www.journal-of-hepatology.eu/article/S0168-8278(17)32399-1/fulltext
Van de Velde-Kossmann, K. M. Skin examination: an important diagnostic tool in renal failure patients. Blood Purification [revista electrónica] 45.1-3 (2018): 187-193. [accedido 11 sep 2020]. Disponible en: https://www.karger.com/Article/FullText/485156
Durand F, Graupera I, Ginès P, Olson J, Nadim M. Pathogenesis of Hepatorenal Syndrome: Implications for Therapy. American journal of kidney diseases [revista electrónica] 2016 [accedido 18 sep 2020]. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0272638615012238
Diaconescu D, Pantea Stoian A, Socea L, Stanescu A, Iancu M, Socea B, et al. Hepatorenal syndrome: a review. Archives of the Balkan Medical Union. [revista electrónica] 2018 [accedido 18 sep 2020]. Disponible en: https://umbalk.org/wp-content/uploads/2018/06/10.Hepatorenal-syndrome-a-review.pdf
Solé C, Pose E, Solà E, Ginès P. Hepatorenal syndrome in the era of acute kidney injury. Liver International [revista electrónica] 2018;38:1891–1901. [accedido 18 sep 2020]. Disponible en: https://onlinelibrary.wiley.com/doi/pdf/10.1111/liv.13893
Nguyen-Tat M, Jäger J, Rey J, Nagel M, Labenz Ch, Wörns M,et al. Terlipressin and albumin combination treatment in patients with hepatorenal syndrome type 2. United European Gastroenterol J. [revista electrónica] 2019;7(4):529-537.[accedido 18 sep 2020]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6488797/
Piano S, Tonon M, Angeli P. Manejo de ascitis y síndrome hepatorrenal. Hepatología internacional [revista electrónica] (2018) , 12 (1), 122-134. [accedido 18 sep 2020]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28836115/
Seckin Y, Yigit A, Yesilada E, Gulbay G, Cagin, Gozukara H, et al. Association of eNOS Gene Polymorphisms G894T and T-786C with Risk of Hepatorenal Syndrome.Gastroenterol Res Pract [revista electrónica] 2016; 2016:2579626 [accedido 18 sep 2020]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4995323/
Abdel-Razik A, Mousa N, Abdelsalam M, Abdelwahab A, Tawfik M, Tawfik A, et al. Endothelin-1/Nitric Oxide Ratio as a Predictive Factor of Response to Therapy With Terlipressin and Albumin in Patients With Type-1 Hepatorenal Syndrome. Front Pharmacol.[revista electrónica] 2020;11:9. [accedido 18 sep 2020]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7006449/
Afonso Barata J. Abordagem e Tratamento do Síndrome Hepatorrenal [Doctor]. Universidade da Beira interior; 2016. [accedido 18 sep 2020]. Disponible en: https://ubibliorum.ubi.pt/bitstream/10400.6/5339/1/4840_9622.pdf
Kazory A, Ronco C. Hepatorenal syndrome or hepatocardiorenal syndrome: revisiting basic concepts in view of emerging data. Cardiorenal Med [revista electrónica] 2019;9:1–7 [accedido 18 sep 2020]. Disponible en: https://www.karger.com/Article/FullText/492791
Acevedo J, Cramp M. Hepatorenal syndrome: Update on diagnosis and therapy. World J Hepatol. [revista electrónica] 2017;9(6):293-299. [accedido 18 sep 2020]. Disponible en: ncbi.nlm.nih.gov/pmc/articles/PMC5332418/.
Pazmiño Antepara BS, Uriarte Carrasco JE, Navarro Chavez M. Prevalencia de síndrome hepatorrenal en paciente con cirrosis hepática en el hospital docente de especialidades dr. Abel Gilbert Ponton desde enero del 2015 a diciembre del 2017. [Doctor]. Universidad de Guayaquil; 2017. [accedido 18 sep 2020]. Disponible en: http://repositorio.ug.edu.ec/bitstream/redug/31393/1/PAZMI%c3%91O%20ANTEPARA%20BISMARCK%20STIVEN.pdf.
Facciorusso, A. Hepatorenal Syndrome Type 1: Current Challenges And Future Prospects. Therapeutics and Clinical Risk Management, [revista electrónica]. 2019, vol. 15, p. 1383. [accedido 18 sep 2020]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6886557/
Enescu A, Petrescu F, Mitru? P, Petrescu IO, P?dureanu V, Enescu A?. Hepatorenal Syndrome: Diagnosis and Treatment - newsreel. Rom J Intern Med [revista electrónica]. 2016 Sep 1;54(3). [accedido 18 sep 2020]. Disponible en: https://content.sciendo.com/view/journals/rjim/54/3/article-p143.xml
Garzón Ospina L, Grisman Laverde J, Albán Tapia J, Olmedo Cahuasquí J. Hiponatremia y síndrome hepatorrenal. Recimundo, 4(3), 102-117..(3).julio.2020.102-117. [accedido 18 sep 2020]. Disponible en: http://recimundo.com/index.php/es/article/view/854
Dundar H, Y?lmazlar T. Management of hepatorenal syndrome. World J Nephrol. [revista electrónica] 2015;4(2):277-286. [accedido 18 sep 2020]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4419138/
Altun R, Korkmaz M, Y?ld?r?m E, Öcal S, Akba? E, Selçuk H. Terlipressin and albumin for type 1 hepatorenal syndrome: does bacterial infection affect the response?. Springerplus. [revista electrónica] 2015;4:806 [accedido 18 sep 2020]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4689717/
Mattos ÁZ, de Mattos AA, Méndez-Sánchez N. Hepatorenal syndrome: Current concepts related to diagnosis and management. Ann Hepatol [revista electrónica] 2016 Jul-Aug;15(4):474-81. [accedido 18 sep 2020]. Disponible en: https://www.sciencedirect.com/science/article/pii/S1665268119311354?via%3Dihub
Salerno F, Navickis R, Wilkes M. Albumin treatment regimen for type 1 hepatorenal syndrome: a dose-response meta-analysis. BMC Gastroenterol.[revista electrónica] 2015;15:167.[accedido 18 sep 2020]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4660686/
Simonetto DA, Gines P, Kamath PS. Hepatorenal syndrome: pathophysiology, diagnosis, and management. BMJ [revista electrónica] 2020 Sep 14;370:24. [accedido 31 oct 2020]. Disponible en: https://www.bmj.com/content/370/bmj.m2687
Aparici C, Bains S, Carlson D, Qian J, Liou D, Wojciechowski D, et al. Recovery of Native Renal Function in Patients with Hepatorenal Syndrome Following Combined Liver and Kidney Transplant with Mercaptoacetyltriglycine-3 Renogram: Developing a Methodology. World J Nucl Med [revista electrónica] 2016;15(1):44-49. [accedido 31 oct 2020]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4729014/
Belcher J, Coca S, Parikh C. Creatinine Change on Vasoconstrictors as Mortality Surrogate in Hepatorenal Syndrome: Systematic Review & Meta-Analysis. PLoS One. [revista electrónica] 2015;10(8):e0135625. [accedido 31 oct 2020]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4546623/
Sridharan K, Sivaramakrishnan G. Vasoactive Agents for Hepatorenal Syndrome: A Mixed Treatment Comparison Network Meta-Analysis and Trial Sequential Analysis of Randomized Clinical Trials. J Gen Intern Med. [revista electrónica] 2018;33(1):97-102. [accedido 31 oct 2020]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5756164/
Ojeda-Yuren AS, Cerda-Reyes E, Herrero-Maceda MR, Castro-Narro G, Piano S. An Integrated Review of the Hepatorenal Syndrome. Ann Hepatol [revista electrónica] 2020 Aug 23:S1665-2681(20)30141-1. [accedido 31 oct 2020]. Disponible en: https://www.sciencedirect.com/science/article/pii/S1665268120301411?via%3Dihub
Lagos C, Molina I, Muñoz C, Figueroa L, Soto R, Valenzuela Carlos. El uso combinado de terlipresina más albúmina es más efectivo que la albúmina por sí sola en mejorar la función renal en pacientes con cirrosis y síndrome hepatorrenal tipo 1. Gastroenterol latinoam [revista electrónica] 2017; Vol 28, Nº 3: 202-206. [accedido 8 Nov 2020]. https://www.researchgate.net/publication/328428860_El_uso_combinado_de_terlipresina_mas_albumina_es_mas_efectivo_que_la_albumina_por_si_sola_en_mejorar_la_funcion_renal_en_pacientes_con_cirrosis_y_sindrome_hepatorrenal_tipo_1/citation/download
Angeli P, Garcia-Tsao G, Nadim M, Chirag R. Parikh C. News in pathophysiology, definition and classification of hepatorenal syndrome: A step beyond the International Club of Ascites (ICA) consensus document. J Hepatol. [revista electrónica] 2019; 71(4):811-822. [accedido 8 Nov 2020]. Disponible en: https://www.journal-of-hepatology.eu/article/S0168-8278(19)30410-6/fulltext.
Gupta K, Rani P , Rohatgi A , Verma M , Handa S , Dalal K, et al.Noradrenaline for reverting hepatorenal syndrome: a prospective, observational, single-center study. Clin Exp Gastroenterol. [revista electrónica] 2018;11:317-324. [accedido 8 Nov 2020]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6151092/
Ruiz Blard E, Baiges A, Turon F, Hernández V, García Pagán J. Derivación portosistémica intrahepática transyugular precoz: cuándo, cómo y a quién. Science Direct [revista electrónica] 2016 [accedido 8 Nov 2020]. Disponible en:https://www.sciencedirect.com/science/article/abs/pii/S021057051500237X
Sendra C, Silva Ruiz MDP, Ferrer Rios MT, Alarcon Gacia JC, Pascasio Acevedo JM. La noradrenalina como tratamiento médico alternativo a la terlipresina en el manejo del síndrome hepatorrenal tipo 1. Gastroenterología y hepatología [revista electrónica] 41(7), 440-441 (2018). [accedido 8 Nov 2020]. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0210570517301991
Iqbal J, Khalid MA, Hanif FM y col. Correlation Between MELD and UNa/K Ratio in Predicting Renal Dysfunction in Cirrhotic Patients. J Transl Int Med [revista electrónica]. 2018; 6 (4): 181-184. [accedido 8 Nov 2020]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6326034/
Puentes JCP, Rocha H, Nicolau S, Ferrão G. Effectiveness of the MELD/Na Score and the Child–Pugh Score for the Identification of Palliative Care Needs in Patients with Cirrhosis of the Liver. Indian J Palliat Care [revista electrónica]. 2018; 24 (4): 526-528. [accedido 8 Nov 2020]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6199842/
Mateos B, Martín-Mateos R, Lledó JL, Téllez L, Albillos A. Insuficiencia renal en la cirrosis: formas clínicas y tratamiento. Medicine - Programa de Formación Médica Continuada Acreditado [revista electrónica]. 2016, vol. 12, no 12, p. 698-701. [accedido 8 Nov 2020]. Disponible en: https://www.sciencedirect.com/science/article/pii/S0304541216300774.
Heidemann J, Bartels C, Berssenbrügge C, Schmidt H, Meister T. Hepatorenal syndrome: outcome of response to therapy and predictors of survival. Gastroenterol Res Pract. [revista electrónica] 2015; 2015:457613 [accedido 8 Nov 2020]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4422997/
Marciano S, Díaz JM, Dirchwolf M, Gadano A. Spontaneous bacterial peritonitis in patients with cirrhosis: incidence, outcomes, and treatment strategies. Hepatic medicine: evidence and research [revista electrónica]. 2019, vol. 11, p. 13. [accedido 8 Nov 2020]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6336019/.
Härmälä S, Parisinos C, Ryan J, O'Brien A. Effectiveness of intravenous albumin therapy to prevent spontaneous bacterial peritonitis, renal dysfunction and death in adults with cirrhosis: a protocol for a systematic review. BMJ Open [revista electrónica]. 2019 Jan 29;9(1):e025664. [accedido 8 Nov 2020]. Disponible en: https://bmjopen.bmj.com/content/9/1/e025664.long
Stine JG, Wang J, Cornella SL, Behm BW, Henry Z, Shah NL, et al. Treatment of Type-1 Hepatorenal Syndrome with Pentoxifylline: A Randomized Placebo Controlled Clinical Trial. Ann Hepatol [revista electrónica]. 2018;17(2):300-306. [accedido 8 Nov 2020]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7485043/
Moreau R, Elkrief L, Bureau C, Perarnau JM, Thévenot T, Saliba F, et al. Effects of Long-term Norfloxacin Therapy in Patients With Advanced Cirrhosis. Gastroenterology [revista electrónica]. 2018 Dec;155(6):1816-1827. [accedido 8 Nov 2020]. Disponible en: https://www.gastrojournal.org/article/S0016-5085(18)34891-1/fulltext?referrer=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F
Kang SH, Lee YB, Lee JH, Nam JY, Chang Y, Cho H, et al. Rifaximin treatment is associated with reduced risk of cirrhotic complications and prolonged overall survival in patients experiencing hepatic encephalopathy. Alimentary Pharmacology & Therapeutics [revista electrónica]. 2017, vol. 46, no 9, p. 845-855. [accedido 8 Nov 2020]. Disponible en: https://onlinelibrary.wiley.com/doi/abs/10.1111/apt.14275.
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