Hepatorenal Syndrome, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

This book describes Hepatorenal Syndrome, Diagnosis and Treatment and Related Diseases
Hepatorenal syndrome is a disorder in which there is continual failure of the kidneys seen in patients with liver failure often caused by cirrhosis of the liver.
It is a severe complication that can result in death.
When the kidneys stop functioning, the toxins begin to accumulate in the body.
Ultimately, this leads to liver failure.
This syndrome is a interplay of renal dysfunction that causes kidney failure in patients with liver cirrhosis and ascites which also leads to liver failure.
Liver failure leads to kidney failure.
Hepatorenal syndrome is produced by the vasoconstriction of large and small renal arteries and the impaired renal perfusion that occurs
Criteria for diagnosis of hepatorenal syndrome in cirrhosis
1.Cirrhosis with ascites.
2.Serum creatinine >1.5 mg/dL (133 μmol/L).
3.Absence of shock.
4.Absence of hypo-volemia as seen by no sustained improvement of renal function (creatinine reducing to

• Language: English
• Publisher: Kenneth Kee
• Release date: Jan 29, 2018
• ISBN: 9781370228652

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

Hepatorenal Syndrome,

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2018 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Hepatorenal Syndrome, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What The patient Need to Treat Hepatorenal Syndrome)

This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If the patient would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.

This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 1000 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Hepatorenal Syndrome

Hepatorenal syndrome is a disorder in which there is continual failure of the kidneys seen in patients with liver failure often caused by cirrhosis of the liver.

It is a severe complication that can result in death.

When the kidneys stop functioning, the toxins begin to accumulate in the body.

Ultimately, this leads to liver failure.

This syndrome is a interplay of renal dysfunction that causes kidney failure in patients with liver cirrhosis and ascites which also leads to liver failure.

Hepatorenal syndrome is produced by the vasoconstriction of large and small renal arteries and the impaired renal perfusion that occurs

The syndrome may indicate an imbalance between renal vasoconstrictors and vasodilators.

Plasma levels of a number of vasoconstricting substances such as angiotensin, antidiuretic hormone, and norepinephrine are raised in patients with cirrhosis.

Renal perfusion seems to be protected by vasodilators, such as prostaglandins E2 and I2 and atrial natriuretic factor.

Non-steroidal anti-inflammatory drugs (NSAIDs) restrict prostaglandin synthesis.

They may increase renal vasoconstriction, with an effective drop in glomerular filtration.

Therefore the use of NSAIDs is contraindicated in patients with decompensated cirrhosis.

Many patients with hepatorenal syndrome are observed to have minimal histological changes in the kidneys.

Kidney function normally recovers when patients with cirrhosis and hepatorenal syndrome go through liver transplantation.

A kidney donated by a patient dying from hepatorenal syndrome functions normally when transplanted into a renal transplant recipient.

Hepatorenal syndrome is an effect of end-stage liver disease which happens in patients who have chronic liver dysfunction with cirrhosis and ascites and also in acute liver failure.

In hepatorenal syndrome (HRS) there is damaged renal function which is often triggered by events lowering blood pressure

Factors precipitating hepatorenal syndrome are infections, alcoholic hepatitis and bleeding

Incidence

HRS is a frequent complication of end-stage liver disease.

The incidence of HRS is not known.

It is believed that 35-40% of patients with end-stage liver disease and ascites ultimately develop HRS.

Diagnostic criteria for hepatorenal syndrome

HRS is basically a diagnosis of exclusion - i.e. there is an absence of other recognizable causes of renal failure.

The diagnostic criteria have been defined as:

Criteria for diagnosis