Hepatorenal syndrome differential diagnosis: Difference between revisions
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==Overview== | ==Overview== | ||
Many other diseases of the kidney are associated with liver disease and must be excluded before making a diagnosis of hepatorenal syndrome. | Many other diseases of the [[kidney]] are associated with [[liver]] disease and must be excluded before making a diagnosis of hepatorenal syndrome. | ||
==Differentiating Hepatorenal Syndrome from other Diseases== | ==Differentiating Hepatorenal Syndrome from other Diseases== | ||
Many other diseases of the kidney are associated with liver disease and must be excluded before making a diagnosis of hepatorenal syndrome. | Many other diseases of the [[kidney]] are associated with [[Liver diseases|liver disease]] and must be excluded before making a diagnosis of hepatorenal syndrome. They include the following: | ||
{| class="wikitable" | {| class="wikitable" | ||
!Variables | !Variables | ||
!Kidney injury associated with infection | ![[Kidney]] injury associated with infection | ||
!Prerenal acute kidney | !Prerenal [[Acute kidney injury|acute kidney injur]]<nowiki/>y | ||
!Hepatorenal syndrome | !Hepatorenal syndrome | ||
!Parenchymal renal disease | !Parenchymal renal disease | ||
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|Mechanism | |Mechanism | ||
Causes | Causes | ||
|Infections, including SBP | |[[Infection|Infections]], including SBP | ||
|Hypovolumia due: | |Hypovolumia due: | ||
gastrointestinal fluid losses | gastrointestinal fluid losses | ||
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diuretic | diuretic | ||
[[non-steroidal anti-inflammatory drug]] | |||
|Splanic vasodalation due to nitic oxide | |Splanic vasodalation due to nitic oxide | ||
|Aminoglycoside therapy | |[[Aminoglycoside]] therapy | ||
Radiocontrast agent | [[Radiocontrast|Radiocontrast agent]] | ||
Sepsis | Sepsis | ||
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|Diagnostic clue | |Diagnostic clue | ||
|History of fever | |History of fever | ||
Blood cultures | [[Blood culture|Blood cultures]] | ||
Ascetic cultures | Ascetic cultures | ||
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Bleeding | Bleeding | ||
Low [[blood pressure]] | |||
Intake of | Intake of [[Non-steroidal anti-inflammatory drug|NSAID]] | ||
|Diagnosis of exclusion: | |Diagnosis of exclusion: | ||
Liver failure + Renal failure | Liver failure + Renal failure | ||
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repleating fluid loss | repleating fluid loss | ||
|History of: | |History of: | ||
Infections | [[Infection|Infections]] | ||
Injection of Dye | Injection of [[Dye]] | ||
intake of nephrotoxic agent | intake of nephrotoxic agent |
Revision as of 20:32, 21 December 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sunny Kumar MD [2]
Overview
Many other diseases of the kidney are associated with liver disease and must be excluded before making a diagnosis of hepatorenal syndrome.
Differentiating Hepatorenal Syndrome from other Diseases
Many other diseases of the kidney are associated with liver disease and must be excluded before making a diagnosis of hepatorenal syndrome. They include the following:
Variables | Kidney injury associated with infection | Prerenal acute kidney injury | Hepatorenal syndrome | Parenchymal renal disease |
---|---|---|---|---|
Mechanism
Causes |
Infections, including SBP | Hypovolumia due:
gastrointestinal fluid losses bleeding diuretic |
Splanic vasodalation due to nitic oxide | Aminoglycoside therapy
Sepsis |
Diagnostic clue | History of fever
Ascetic cultures |
History of:
Bleeding Low blood pressure Intake of NSAID |
Diagnosis of exclusion:
Liver failure + Renal failure no apparent cause for the acute kidney injury No improvement on removing nephrotoxic agent repleating fluid loss |
History of:
Injection of Dye intake of nephrotoxic agent |
Prognosis | Good | Good | Poor | Good |