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Alcoholic cirrhosis-associated hepatorenal syndrome treated with vasoactive agents

Nature Clinical Practice Nephrology volume 2, pages 169–172 (2006)Cite this article

Abstract

Background A 35-year-old man with alcoholic cirrhosis, ascites and alcoholic hepatitis presented with new-onset renal insufficiency of unclear etiology after recovery from an episode of gastrointestinal bleeding. Renal function continued to worsen after cessation of diuretic therapy and initiation of volume resuscitation.

Investigations Physical examination, abdominal ultrasound, liver tests, basic metabolic panel, abdominal paracentesis, renal function tests, 24-h urine collections.

Diagnosis Type 1 hepatorenal syndrome (HRS).

Management Intravascular volume resuscitation with normal saline and albumin followed by oral midodrine plus subcutaneous octreotide therapy. This regimen was continued until improvement and subsequent normalization of the serum creatinine.

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Figure 1: Changes in the patient's blood urea nitrogen levels (mmol/l) during the course of hospitalization.

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Acknowledgements

We would like to acknowledge Dr TB Reynolds as an inspirational teacher and pioneer in the fields of hepatology and nephrology. His lasting personal and professional influence on the authors is profound, and his contributions to academic medicine are legendary.

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Authors and Affiliations

  1. a senior Gastroenterology and clinical research fellow based at the Center for Health Sciences and the David Geffen School of Medicine at University of California, Los Angeles, CA, USA

    Eric Esrailian

  2. Professor of Medicine, Chief of Liver Service and Medical Director of Liver Transplantation at Loma Linda University Medical Center, Loma Linda, CA, USA

    Bruce A Runyon

Authors
  1. Eric Esrailian
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  2. Bruce A Runyon
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Corresponding author

Correspondence to Bruce A Runyon.

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The authors declare no competing financial interests.

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Esrailian, E., Runyon, B. Alcoholic cirrhosis-associated hepatorenal syndrome treated with vasoactive agents. Nat Rev Nephrol 2, 169–172 (2006). https://doi.org/10.1038/ncpneph0114

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