Hepatorenal Syndrome (HRS) > Liver and Kidney Failure!

One of the common misconceptions of the public regarding how the body works is the belief that body systems act independently. In reality, our body is one environment, and our body’s organs and systems act in coordination with each other. Any damage or pathology to one body system can affect others at varying degrees. The liver is a prime example of this phenomenon. A pathology in the liver can affect the gastrointestinal tract, the blood and its coagulation, the nervous system and wakefulness, the heart and its circulation, and the kidneys. Being such an essential organ to life, the liver can cause severe damage to other organs and even death from their failure if not properly treated.

What is hepatorenal syndrome and how does it occur?

Hepatorenal syndrome is the occurrence of kidney failure in a patient with a severe chronic or acute liver dysfunction. It is usually found in patients with chronic liver disease and cirrhosis, which is usually coupled with ascites (the accumulation of fluid in the abdomen) and hematemesis (bloody vomiting). The peculiar characteristic of hepatorenal syndrome is that kidney failure is closely related to the liver’s condition that there are no detectable causes for kidney damage, and that kidney functions can return to normal after liver transplantation.

There is no certain mechanism of how the condition develops, but it is thought to result from the activation of a certain chemical system in the kidney called the renin-angiotensin system as well as the sympathetic nervous system. Such activation is reversible, and that explains why such damage is reversible once the liver is transplanted. One of the commonest complications of ascites is infection, which is better known as spontaneous bacterial peritonitis or SBP. This infection can accelerate the rate of development of hepatorenal syndrome along with other conditions such as low blood pressure and low sodium level. Hepatorenal syndrome is not rare by any means, and more than 4 in every 10 people with chronic liver disease develop the condition.

Written by Martin Davis