HEPATORENAL SYNDROME IN ASSOCIATION WITH ALCOHOLIC LIVER DISEASE.
Main Article Content
Keywords
Alcoholic Hepatitis, Hepatorenal Syndrome, Alcohol Induced Disorders
Abstract
Hepatorenal syndrome is an acute renal lesion in which histologically there is no evidence of structural abnormalities in the kidneys, as a consequence of acute decompensation of cirrhosis, mainly of alcoholic etiology. Its pathophysiology is not yet fully defined; however, its progression is of rapid onset and is associated with complications which, if not treated promptly, have high morbimortality. In Ecuador, local studies show that emergent care for hepatorenal complications secondary to alcoholic etiology are frequent in the clinical area. The definitive treatment for hepatorenal syndrome, both type 1 and 2, is liver transplantation. Currently, medical progress has given way to the study of other therapeutic alternatives such as terlipressin and even the use of probiotics for regenerative purposes.
General objective: To describe hepatorenal syndrome in association with alcoholic liver disease.
Methods: A narrative literature review study was conducted in a broad literature review of hepatorenal syndrome in association with alcoholic liver disease. As part of the PRISMA strategy, information is collected in scientific databases, mainly Cochrane, Pub Med, Science Direct and Scielo.
Results: Alcoholic liver disease represents the main cause of liver damage and hospital admission in Ecuador, being represented in 33% of all cases, being directly related to the generation of kidney injury subsequent to liver damage in 16.7% of cases. On the basis of the diagnosis, hepatorenal syndrome is characterized by elevation of azoates in the context of a patient with liver damage and ascites that does not improve after 48 hours of discontinuation of diuretics and volume expansion with albumin. The main pharmacological treatment is the use of terlipressin to improve kidney function during the first 14 days, although if there is no timely correction, the definitive treatment is still liver transplantation.
Conclusions: In Ecuador, local studies show that emergent care for hepatorenal complications secondary to alcoholic etiology is frequent in the clinical area. The definitive treatment for both type 1 and 2 hepatorenal syndrome is liver transplantation. Currently, medical advances have given way to the study of other therapeutic alternatives such as terlipressin and even the use of probiotics for regenerative purposes.
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Santiago David Maldonado Peñafiel
Estudiante de la carrera de Medicina de la Universidad Católica de Cuenca
Andrés Santiago Bueno Castro
Docente Universidad Católica de Cuenca