Hepatorenal Syndrome (HRS)
Hepatorenal Syndrome (HRS) is a topic covered in the Pocket ICU Management.
Anesthesia Central provides drug, diagnostic test and procedure information. Explore these free sample topics:
-- The first section of this topic is shown below --
First Things First (assess & treat for the following)
- Assess airway, breathing, circulation
- Determine the severity of liver disease, presence of ascites.
- Assess intravascular volume status.
- Assess renal function.
- Consider admission of patient to intensive care unit.
- Insert Foley catheter and measure strict intake/output.
- If breathing is stable and there is no evidence of pulmonary edema, administer a trial of volume expansion using albumin infusion 1 g/kg IV (not to exceed 100 g).
- Consider central venous pressure monitoring.
- Adjust medications for renal and hepatic insufficiency
- Determine the type of hepatorenal syndrome (HRS) if present.
- Type 1 HRS: double creatinine to >2.5 mg/dL or 50% decrease in creatinine clearance to < 20 ml/min in < 2 weeks
- Type 2 HRS: progressive decline in renal function with creatinine >1.5 mg/dL, paralleling the development of refractory ascites