Author/Editor		Hafner, Matjaž
Title		Hepatorenalni sindrom
Translated title		Hepatorenal syndrome
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 70, št. 12
Publication year		2001
Volume		str. 747-50
Language		slo
Abstract		Background. Hepatorenal syndrome (HRS) is a common complication of advanced hepatic disease characterized by marked abnormalities in arterial circulation and by renal failure. An extreme arteriolar vasodilatation located in the splanchnic circulation results in a reduction of total systemic vascular resistence and arterial hypotension. Vasoconstriction occurs in the renal circulation as in all other extrasplanchnic vascular territories. In the kidney, marked renal vasoconstriction results in a low glomerular filtration rate. Conclusions. The diagnosis of HRS is currently based on exclusion of other causes of renal failure. Prognosis of patients with HRS is very poor. Liver transplantation is the best therapeutic option, but it is seldom applicable due to the short survival expectancy of most patients with HRS, particularly those with the rapidly progressive type of HRS. New therapies developed during the last few years, such as the use of systemic vasoconstrictors or transjugular intrahepatic portosystemic shunts (TIPS) apper promising. Such treatments are of interest not only as a bridge to liver transplantation but also as a therapy for patients who are not candidates for transplantation.
Summary		Izhodišča. Hepatorenalni sindrom je pogost zaplet napredovale jetrne bolezni, za katerega so značilne motnje v arterijskem obtoku in ledvična odpoved. Izrazita arteriolarna vazodilatacija v področju splahničnega obtoka povzroči zmanjšanje celotnega sistemskega žilnega upora in posledično arterijsko hipotenzijo. Razen v splanhničnem področju pride v obtoku do vazokonstrikcije. Vazokonstrikcija v ledvicah povzroči zmanjšanje glomerularne filtracije.Zaključki. Diagnozo HRS postavimo z izključitvijo drugih vzrokov ledvične odpovedi. Prognoza bolnikov s HRS je zelo slaba. Najboljši način zdravljenja je presaditev jeter, vendar jo je zaradi kratkega preživetja bolnikov, predvsem tistih s hitro napredujočo obliko HRS, težko uresničiti. V zadnjih letih dajejo obetavne rezultate novi načini zdravljenja, kot sta uporaba sistemskih vazokonstriktorjev in uvedba transjugularnega intrahepatičnega portosistemskega šanta (TIPS). Obe vrsti zdravljenja nista uporabni le kot premostitev do presaditve jeter, ampak tudi pri bolnikih, ki niso kandidati za presaditev.
Descriptors		HEPATORENAL SYNDROME