TY - CHAP M1 - Book, Section TI - Hepatorenal Syndrome A1 - Wong, Florence A2 - Lerma, Edgar V. A2 - Rosner, Mitchell H. A2 - Perazella, Mark A. Y1 - 2017 N1 - T2 - CURRENT Diagnosis & Treatment: Nephrology & Hypertension, 2e AB - Renal dysfunction is a common and serious problem in patients with advanced liver cirrhosis, estimated to occur in 20% of hospitalized patients with cirrhosis, and even more commonly at 54% in the outpatient setting. Renal dysfunction in cirrhosis has always been regarded as being related to the hemodynamic changes of systemic arterial vasodilatation and paradoxical renal vasoconstriction peculiar to cirrhosis without any structural changes in the kidneys. Such cases of renal dysfunction are known as functional renal failure and the prototype is hepatorenal syndrome (HRS). However, it is now recognized that many liver conditions such as alcoholic cirrhosis or hepatitis C can cause structural renal diseases, and yet the same patients can also develop hemodynamic abnormalities as cirrhosis advances, predisposing them to functional renal failure. Therefore, the demarcation between functional and structural renal diseases is no longer as clear as once thought. Furthermore, many common systemic conditions such as diabetes can cause both cirrhosis and nephropathy, once again blurring the separation between structural and functional renal diseases. Therefore, the concept of renal dysfunction in cirrhosis has been evolving, and that also includes redefining HRS, especially in light of recent changes in the definition of acute kidney injury (AKI) by the nephrology community. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/07 UR - accessmedicine.mhmedical.com/content.aspx?aid=1149112420 ER -