Hepatorenal syndrome

Alternative names:

bile nephrosis; cholemic nephrosis; Flint's syndrome; Heyd's syndrome

Treatment:

Treatment is directed to improving liver function, if possible, and to ensuring that circulating blood volume and cardiac output (heart pumping action) are adequate. The disorder is generally treated in the same manner as kidney failure from any cause. All unnecessary drugs (particularly neomycin, NSAIDS, and diuretics) are stopped. Dialysis may improve symptoms.

Surgical placement of a shunt from the abdominal space (peritoneum) to the jugular vein or superior vena cava (called a Levine shunt) may reduce ascites and reverse some of the symptoms of kidney failure.

Expectations (prognosis):

The probable outcome is poor. Death commonly occurs as a result of secondary infections or hemorrhage.

Complications:

• secondary infections
• bleeding
• hepatic coma
• end-stage renal disease
• fluid overload with subsequent congestive heart failure or pulmonary (lung) edema
• damage and failure of multiple organ systems

Calling your health care provider:

This disorder most often is diagnosed in the hospital during treatment for a liver disorder.