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Kipnowski J, Düsing R, Kramer HJ. Hepatorenales syndrom. [Hepato-renal syndrome (author's transl)]. Klin Wochenschr. 1981;59(9):415-24doi: 10.1007/BF01695895.
Kipnowski, J., Düsing, R., & Kramer, H. J. (1981). Hepatorenales syndrom. [Hepato-renal syndrome (author's transl)]. Klinische Wochenschrift, 59(9), 415-24. https://doi.org/10.1007/BF01695895
Kipnowski, J, et al. "Hepatorenales syndrom." [Hepato-renal syndrome (author's transl)]. Klinische Wochenschrift vol. 59,9 (1981): 415-24. doi: https://doi.org/10.1007/BF01695895
Kipnowski J, Düsing R, Kramer HJ. Hepatorenales syndrom. [Hepato-renal syndrome (author's transl)]. Klin Wochenschr. 1981 May 04;59(9):415-24. doi: 10.1007/BF01695895. German. PMID: 7278084.
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Klin Wochenschr. 1981 May 04;59(9):415-24. doi: 10.1007/BF01695895.

[Hepato-renal syndrome (author's transl)].

Klinische Wochenschrift

[Article in German]
J Kipnowski, R Düsing, H J Kramer

PMID: 7278084 DOI: 10.1007/BF01695895

Abstract

The hepato-renal syndrome is defined as potentially reversible functional renal failure associated with acute fulminant hepatitis or, more often, with advanced chronic liver failure. It is characterized by oliguria, azotemia, retention of sodium and water with formation of ascites, and hyponatremia. While urinary sodium concentration of less than 10 mEq/l reflects intact tubular sodium absorption, the kidney lacks the ability for adequate free-water generation. This condition must be separated from specific renal diseases which may arise during the course of intra-or extrahepatic diseases and which must be classified accordingly. Pathophysiological aspects of the hepa-to-renal syndrome include hemodynamic factors, such as changes in intrarenal blood flow distribution in the presence of elevated intrarenal and reduced peripheral vascular resistance. The functional relationship of vasoconstrictor, sodium retaining, and anti-diuretic hormones (e.g., renin-angiotensin, aldosterone, and vasopressin) to vasodilator, diuretic, and natriuretic hormonal factors (e.g., prostaglandins, kinins, and natriuretic hormone) may be altered as well. Finally, a pre- and intrahepatic spillover resulting in decreased endotoxin clearance must be considered. Due to the lack of understanding of their complex interactions, so far pharmacological and therapeutic approaches remained ineffective to correct at least some of these factors. Today, recovery from hepato-renal syndrome will, therefore, mainly depend on the course of the underlying liver disease.

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