Treatment of acute renal liver syndrome in resuscitation

The article was consulted professionally by Master, Dr. Nguyen Le Duc Hoang – Emergency Resuscitation Doctor – Emergency Resuscitation Department – Share99 Da Nang International Hospital. The doctor has extensive experience in the treatment of Resuscitation – Adult Emergency.

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Acute hepatic syndrome is an extremely dangerous condition that affects the patient's life. This is a form of progressive renal failure seen in people with severe liver damage, most commonly caused by cirrhosis of the liver. When the kidneys stop working, toxins begin to accumulate in the body and eventually lead to liver failure.

1. Symptoms of acute hepatic syndrome

Symptoms of acute hepatorenal syndrome (HRS) should be treated as a medical emergency. If you experience any of the symptoms listed below, contact your doctor or visit a Medical facility immediately. Common symptoms of HRS include:

  • Confusion
  • Mesmerizing
  • Nausea
  • vomit
  • Dementia
  • Weight gain
  • Jaundice and yellow eyes
  • Decreased urine volume
  • Dark-colored urine
  • Large abdomen

There are two types of HRS. HRS type 1 has rapid renal failure and excessive production of creatinine. HRS type 2 has gradual kidney damage, slower progress, and more difficult-to-detect symptoms.

HRS is an extremely serious condition and most patients die. According to a study in the Journal of Clinical Biomedical Diseases, people with type 1 HRS have an average life time of two weeks and will die within 8 to 10 weeks, unless the patient has an early liver transplant. The average life time for type 2 is about six months.


The majority of patients with HRS die

2. Causes of acute renal liver syndrome

HRS is one of the complications of liver disease and most often cirrhosis of the liver. If you have cirrhosis of the liver, some factors increase your risk of HRS, including:

  • Unstable blood pressure
  • Use of weeds
  • Acute alcoholic hepatitis
  • Gastric hemorrhage
  • Spontaneous Bacterial Peritonitis
  • Other infections (especially infections in the kidneys)

3. Diagnosis of acute renal liver syndrome

If the doctor suspects that the patient has acute hepatic and renal syndrome when going to a medical facility for emergency, the doctor will look for signs of HRS such as:

  • Swollen breast tissue
  • Ulcers on the skin
  • Fluid accumulates in the abdomen
  • Jaundice due to excess of bilirubin in the blood
  • tired
  • Abdominal pain
  • uncomfortable
  • Spleen
  • Temporary impairment of brain function (confusion and/or memory loss) associated with hepatic encephaity

There are no specific tests confirming HRS. Therefore, this pathology is diagnosed only by excluding other causes of acute renal failure in patients with advanced liver disease.

Doctors will conduct a thorough clinical review, a detailed history of illness and prescribe different tests. In this way, the doctor will determine whether the patient has other conditions such as progressive liver failure with hypertension and exclude other causes that also cause kidney failure, such as:

  • Pathology in the urinary tract or in the kidneys
  • Bacterial infections
  • Shock caused by a sudden decrease in blood flow in the body
  • Some medications for the condition being used affect renal function, also known as renal toxicity drugs
  • Use of an overdose of weeds

One of the tests used to diagnose HRS is a serum creatinine test. This test reflects the level of kidney activity. One of the signs of HRS is abnormally high levels of creatinine in the blood.

HRS serological tests

Creatinine test helps diagnose kidney activity

4. Handling acute renal liver syndrome in emergency

Liver transplantation is the best treatment for patients with HRS but may not be an option for people with TYPE 1 HRS due to possible illness for the surgery. Those who are not eligible for transplantation or waiting for a donor will be treated with hemodialysis or medication to improve blood flow to the kidneys.

HRS patients are also advised to avoid dieptics as they may impair renal function or promptly treat infections and maintain electrolytic balance. The main electrolyses in the body include sodium, potassium, calcium, magnesium, phosphates and chloride. The doctor will determine the level of electrolyses in the body with a few tests and plan treatment to solve the electrolye electrolysm imbalance.

In some cases, HRS patients need to have a kidney and liver transplant as the best option. But even after a successful liver transplant, kidney problems can persist, sometimes dialysis is still required. Dialysis is a treatment that removes waste, salt and excess water from the body and other functions that are normally performed by healthy kidneys.

Other options for those who cannot have an organ transplant or are waiting to receive a transplant, include:

  • Vascular drugs raise blood pressure in case blood pressure is too low
  • Use Albumin to improve kidney function

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Article reference source:,


  • Hepatic and renal syndrome (HRS) in patients with advanced cirrhosis
  • What is hepatic and renal syndrome? Manifestations of the disease
  • Treatment regimen for hepatic and renal syndrome

  • Application of vascular drugs in the treatment of
  • Can naphazolin nasal drop be used for pregnant women?
  • Risk factors for renal artery stenosis

About: Minh Quynh

b1ffdb54307529964874ff53a5c5de33?s=90&d=identicon&r=gI am the author of I had been working in Vinmec International General Hospital for over 10 years. I dedicate my passion on every post in this site.


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