All are True about hepatorenal syndrome except -
Hepatorenal syndrome - It is functional renal failure without renal pathology that occurs in about 10% of patients with advanced cirrhosis or acute liver failure. There are marked disturbances in aerial renal circulation in patients with HRS Increase in vascular resistance(renal vasoconstriction ) accompanied by decrease in systemic vascular resistance . The reason for renal vasoconstriction is multifactorial and poorly understood. It is of two types - HRS1-it is characterized by proggressive impairment in renal function and significant reduction in creatinine clearance within 2 weeks of presentation . HRS2-reduction in GFR and increase in creatinine ,but it is stable and has better outcome than type 1 Currently, patients are treated with midodrine (alpha agonist) ,octreotide and intravenous albumin. The best therapy for HRS IS liver transplantation.(type 1or 2) Ref:Harrison 20 th edition pg no 2413
Seen in advanced stage of cirrhosis
Type II has more serious prognosis than type I
Due to intense hypoperfusion of kidney
Functional renal failure without renal pathology
Kidney