Gundling F, Gülberg V, Schepp W, Mann J
Klinik für Gastroenterologie, Hepatologie und Gastroenterologische Onkologie, Klinikum Bogenhausen, Städtisches Klinikum München GmbH, München.
MMW Fortschr Med. 2008 Apr 10;150 Suppl 1:22-6.
A lot of patients suffering from liver cirrhosis show a decreased renal perfusion and glomerular filtration rate. An impaired renal function is the result of complex e.g. hemodynamic disturbances, resulting of the chronic liver disease. This explains its disposition to renal dysfunction and the higher incidence of acute renal failure in liver cirrhosis. In the case of renal failure hepatorenal syndrome, apart from prerenal, renal and postrenal causes, should be included in the differential diagnosis especially when signs of portal hypertension are apparent regarding its high mortalityand fatal prognosis requiring an immediate therapeutically approach. Special attention must be due to preventive strategies to avoid renal deterioration. This includes simple steps e.g. a careful election of medication but also an adequate therapy of infection-associated complications in patients with liver cirrhosis.
许多肝硬化患者表现出肾灌注和肾小球滤过率降低。肾功能受损是慢性肝病引起的复杂血流动力学紊乱等因素导致的结果。这解释了肝硬化患者易发生肾功能障碍以及急性肾衰竭发病率较高的原因。对于肾衰竭型肝肾综合征，在鉴别诊断时，除肾前性、肾性和肾后性原因外，尤其当门静脉高压体征明显时，因其高死亡率和致命预后需要立即采取治疗措施，故也应考虑在内。必须特别关注预防策略以避免肾功能恶化。这包括一些简单措施，如谨慎选择药物，以及对肝硬化患者感染相关并发症进行充分治疗。
