Štefan Hrušovský, Jana Šedibová, Mária Belovičová, Martin Demeš
Hepatorenal syndrome develops usually in advanced stages of liver cirrhosis with ascitesand its prognosis is poor. It is characterized by retention of creatinine and urea, oliguria, hyponatremia, low natriuresis. In differential diagnosis, prerenal failure, liver and kidney co-morbidity, secondary kidney disturbances and pseudo-hepatorenal syndrome have to be eliminated. The treatment of hepatorenal syndrome consists mainly of withdrawal of diuretics, and i. v. administration of albumin. New place in the treatment is dedicated to continuous i. v. administration of terlipressin at dose 6 mg/d. Administration of midodrine, octreotide and other combinations of vasoactive agents are under investigation. The management has eventually to be completed by the treatment of other complications, such as intercurrent infection, variceal bleeding or hepatic encephalopathy.