Abstract
A 33 year old male is admitted tremulous, with abdominal swelling and jaundice. He has no past medical history, but admits to ‘years’ of alcohol excess and more in the last month. During this time, he has taken no prescribed or over the counter medication. He is normotensive, has marked ascites, with splenomegaly and caput medusa. An ascitic tap demonstrates no white cells or organisms. His urinalysis is negative for blood and protein, and renal ultrasound demonstrates no obstruction. He is oliguric, his serum creatinine is 241 μmol/L and potassium 3.8 mmol/L. Two liters of IV saline has not improved his urine output. Last month, his creatinine was 37 μmol/L. You suspect him to have hepatorenal syndrome.
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Further Reading
Davenport A, et al. Medical management of hepatorenal syndrome. NDT. 2012;27:34–41.
European Association for Study of the Liver. EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis. J Hepatol. 2010;53:397–417.
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Fairweather, J., Findlay, M., Isles, C. (2020). Hepatorenal Syndrome. In: Clinical Companion in Nephrology. Springer, Cham. https://doi.org/10.1007/978-3-030-38320-6_13
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DOI: https://doi.org/10.1007/978-3-030-38320-6_13
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