Tăluță Cornelia, Ștefănescu Horia, Crișan Dana
Liver Unit, Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania.
5th Medical Clinic, Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400139 Cluj-Napoca, Romania.
Diagnostics (Basel). 2024 Apr 30;14(9):938. doi: 10.3390/diagnostics14090938.
More than half of patients hospitalized with liver cirrhosis are dealing with an episode of acute kidney injury; the most severe pattern is hepatorenal syndrome due to its negative prognosis. The main physiopathology mechanisms involve renal vasoconstriction and systemic inflammation. During the last decade, the definition of hepatorenal syndrome changed, but the validated criteria of diagnosis are still based on the serum creatinine level, which is a biomarker with multiple limitations. This is the reason why novel serum and urinary biomarkers have been intensively studied in recent years. Meanwhile, the imaging studies that use shear wave elastography are using renal stiffness as a surrogate for an early diagnosis. In this article, we focus on the physiopathology definition and highlight the novel tools used in the diagnosis of hepatorenal syndrome.
超过半数因肝硬化住院的患者正在经历急性肾损伤发作；最严重的类型是肝肾综合征，因其预后不良。主要的病理生理机制包括肾血管收缩和全身炎症。在过去十年中，肝肾综合征的定义发生了变化，但经过验证的诊断标准仍基于血清肌酐水平，而血清肌酐是一种有多种局限性的生物标志物。这就是近年来新型血清和尿液生物标志物受到深入研究的原因。与此同时，使用剪切波弹性成像的影像学研究将肾硬度作为早期诊断的替代指标。在本文中，我们重点关注病理生理定义，并强调用于诊断肝肾综合征的新型工具。
