Pathophysiological basis of pharmacotherapy in the hepatorenal syndrome
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Pathophysiological basis of pharmacotherapy in the hepatorenal syndrome. / Møller, Søren; Bendtsen, Flemming; Henriksen, Jens H.
In: Scandinavian Journal of Gastroenterology, Vol. 40, No. 5, 2005, p. 491-500.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Pathophysiological basis of pharmacotherapy in the hepatorenal syndrome
AU - Møller, Søren
AU - Bendtsen, Flemming
AU - Henriksen, Jens H
N1 - Keywords: Adenosine; Adrenergic beta-Antagonists; Endothelins; Hepatorenal Syndrome; Humans; Hypertension, Portal; Hypotension; Hypovolemia; Kidney; Liver; Portasystemic Shunt, Transjugular Intrahepatic; Renal Veins; Vasoconstriction; Vasoconstrictor Agents
PY - 2005
Y1 - 2005
N2 - Hepatorenal syndrome (HRS) is a functional and reversible impairment of renal function in patients with severe cirrhosis. Major pathophysiological elements include liver dysfunction, a circulatory derangement with central hypovolaemia and neurohumoral activation of potent vasoactive systems leading to a pronounced renal vasoconstriction. The prognosis of patients with HRS is poor but recent research has spread new enthusiasm for treatment. Efforts at treatment should seek to improve liver function, to ameliorate arterial hypotension and central hypovolaemia, and to reduce renal vasoconstriction. Therefore a combined approach should be applied with reduction of portal pressure with e.g. ss-adrenergic blockers and transjugular intrahepatic portosystemic shunt (TIPS), with amelioration of arterial hypotension and central hypovolaemia with vasoconstrictors such as terlipressin and plasma expanders. New experimental treatments with endothelin- and adenosine antagonists and long-acting vasoconstrictors may have a future role in the management of HRS.
AB - Hepatorenal syndrome (HRS) is a functional and reversible impairment of renal function in patients with severe cirrhosis. Major pathophysiological elements include liver dysfunction, a circulatory derangement with central hypovolaemia and neurohumoral activation of potent vasoactive systems leading to a pronounced renal vasoconstriction. The prognosis of patients with HRS is poor but recent research has spread new enthusiasm for treatment. Efforts at treatment should seek to improve liver function, to ameliorate arterial hypotension and central hypovolaemia, and to reduce renal vasoconstriction. Therefore a combined approach should be applied with reduction of portal pressure with e.g. ss-adrenergic blockers and transjugular intrahepatic portosystemic shunt (TIPS), with amelioration of arterial hypotension and central hypovolaemia with vasoconstrictors such as terlipressin and plasma expanders. New experimental treatments with endothelin- and adenosine antagonists and long-acting vasoconstrictors may have a future role in the management of HRS.
U2 - 10.1080/00365520510012064
DO - 10.1080/00365520510012064
M3 - Journal article
C2 - 16036500
VL - 40
SP - 491
EP - 500
JO - Scandinavian Journal of Gastroenterology
JF - Scandinavian Journal of Gastroenterology
SN - 0036-5521
IS - 5
ER -
ID: 18052996