Kearns P J, Polhemus R J, Oakes D, Rabkin R
J Clin Gastroenterol. 1985 Aug;7(4):341-3. doi: 10.1097/00004836-198508000-00015.
A patient with acute decompensated chronic liver disease developed acute tubular necrosis after an episode of hypotension. Renal failure was managed by hemodialysis for 11 weeks during which period hepatic function improved. Despite persistently severe oliguria, tubular function recovered as judged by a fall in urine sodium content and a rise in specific gravity, suggesting the development of the hepato-renal syndrome. Therefore, a peritoneovenous shunt was inserted. This was followed by a prompt diuresis; further dialysis was not required. This case suggests potential roles for hemodialysis and peritoneovenous shunting in patients with advanced, but potentially reversible hepatic and renal failure and draws attention to the need for formal evaluation of such a possibility.
一名患有急性失代偿性慢性肝病的患者在一次低血压发作后发生了急性肾小管坏死。肾衰竭通过血液透析治疗了11周，在此期间肝功能有所改善。尽管持续存在严重少尿，但根据尿钠含量下降和比重升高判断，肾小管功能恢复，提示肝肾综合征的发生。因此，插入了一根腹腔静脉分流管。随后迅速出现利尿；无需进一步透析。该病例提示血液透析和腹腔静脉分流术在晚期但可能可逆的肝肾功能衰竭患者中的潜在作用，并提请注意需要对这种可能性进行正式评估。
