Department of Transplantation, College of Medicine, Mayo Clinic, Jacksonville, FL 32224, USA.
J Intensive Care Med. 2013 Mar-Apr;28(2):79-92. doi: 10.1177/0885066611408692. Epub 2011 Aug 21.
Hepatorenal syndrome (HRS) is a functional form of acute kidney injury (AKI) associated with advanced liver cirrhosis or fulminant hepatic failure. Various new concepts have emerged since the initial diagnostic criteria and definition of HRS was initially published. These include better understanding of the pathophysiological mechanisms involved in HRS, identification of bacterial infection (especially spontaneous bacterial peritonitis) as the most important HRS-precipitating event, recognition that insufficient cardiac output plays a role in the occurrence of HRS, and evidence that renal failure reverses with pharmacotherapy. Patients with HRS are often critically ill and, by definition, have multiorgan failure. The purpose of this review is to provide an update on novel advances in HRS, with emphasis on the different aspects of management of these patients in the intensive care unit.
肝肾综合征（HRS）是一种与晚期肝硬化或暴发性肝衰竭相关的急性肾损伤（AKI）的功能性形式。自最初的 HRS 诊断标准和定义发表以来，出现了各种新概念。这些概念包括更好地理解 HRS 涉及的病理生理机制，确定细菌感染（特别是自发性细菌性腹膜炎）是 HRS 最重要的诱发事件，认识到心输出量不足在 HRS 的发生中起作用，以及证据表明肾衰竭可以通过药物治疗逆转。HRS 患者通常病情危急，根据定义，他们存在多器官衰竭。本文综述的目的是提供 HRS 新进展的最新信息，重点介绍这些患者在重症监护病房的不同管理方面。
