Hepatorenal Sendrom (HRS)

Year 2014, Volume: 4 Issue: 2, 106 - 113, 02.08.2014

Ebru Yılmaz Nida Dinçel , İpek Kaplan Bulut Sevgi Mir

Abstract

Kronik karaciğer hastalığı zemininde ortaya çıkan morfolojik olarak böbreklerin sağlam olduğu ancak fonksiyonel böbrek yetmezliği tablosu hepatorenal sendrom (HRS) olarak tanımlanır. HRS kötü prognozu nedeniyle sirozun en korkulan komplikasyonudur.

Kronik karaciğer hastalığı zemininde efektif arteriyel kan hacminde azalma ağır hemodinamik değişikliklerle sonuçlanır. Tip 1 HRS aniden gelişen akut böbrek yetmezliği ve diğer organ sistem fonksiyon bozuklukları ile birliktedir. Tip 1 HRS spontan şekilde gelişebilmesine karşın diğer tetikleyici nedenler sonucunda da gelişebilmektedir. Tip 2 HRS siroz ve portal hipertansiyon nedeniyle böbrek fonksiyonlarında yavaş ve ilerleyici azalma ile karakterizedir ve refrakter asit söz konusudur. Karaciğer nakli her iki tip HRS içinde kesin tedavidir. Karaciğer nakli yapılana kadar veya nakil yapılmaya uygun olmayan hastalar için en uygun köprü tedavi terlipresin ve albumin kombinasyonudur.

Keywords

Hepatorenal sendrom; böbrek yetmezliği; siroz

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