The hepatorenal syndrome - newer perspectives

Article Abstract:

Hepatorenal syndrome is a form of kidney failure seen in patients with liver disease. It is usually associated with alcoholic cirrhosis, but the exact cause remains unclear. The only known cure for this otherwise fatal condition is liver transplantation. A recent study has suggested endothelin aberrations may play a role in its development. Patients with hepatorenal syndrome had significantly higher levels of endothelin-1 and endothelin-3 than patients with other forms of kidney failure, patients with liver disease but normal kidney function and healthy subjects. Another study, noting the increased blood circulation and heart rate and decreased blood pressure that accompany this syndrome, has examined subjects for excess production of a vasodilator, an agent causing blood vessels to dilate. Nitric oxide, a known vasodilator, may be a factor in the kidney failure and abnormal blood circulation characteristic of hepatorenal syndrome.

Editorial

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A 23-year-old man with fulminant hepatorenal failure of uncertain cause

Article Abstract:

A 23-year-old man with liver failure was admitted to a hospital to be evaluated for a liver transplant. He had been diagnosed with chronic liver disease 3 years earlier. He was confused and uncommunicative and an ultrasound scan revealed cirrhosis of the liver. He died on the 6th day of hospitalization. A liver biopsy revealed that the copper content of his liver was substantially higher than normal, leading to the diagnosis of Wilson's disease. This disease is characterized by abnormal accumulation of copper, especially in the liver and brain.

Case studies, Wilson's disease

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Fulminant hepatitis associated with hepatitis A virus superinfection in patients with chronic hepatitis C

Article Abstract:

It may be a good idea to vaccinate patients with chronic hepatitis C infection against hepatitis A. Hepatitis A is normally relatively benign in people with no other type of infection. However, 7 of 17 patients who were infected with both the hepatitis C virus and the hepatitis A virus developed rapid liver failure and 6 died. Ten patients who were infected with both the hepatitis B virus and hepatitis A virus fared much better.

Health aspects, Patient outcomes, Mortality, Hepatitis C, Comorbidity, Hepatitis A

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