Aszites und hepatorenales Syndrom

Steib, Christian (2021): Aszites und hepatorenales Syndrom. In: Gastroenterologe, Bd. 16, Nr. 3: S. 172-178

Abstract

In patients with liver cirrhosis and new onset of ascites, paracentesis is recommended. The determination of albumin, cell count and cell differentiation is essential for the first ascites puncture. Stepwise procedure for ascites therapy include moderate sodium consumption, starting an aldosterone antagonist and, if necessary, adding a loop diuretic if the potassium level rises. Patients in whom ascites is not adequately controlled by sodium restriction and diuretics are considered to suffer from refractory ascites. The possibility of listing for liver transplantation has to be discussed in these patients and transjugular intrahepatic portosystemic shunt (TIPS) insertion should be considered. According to the new classification, one no longer classifies hepatorenal syndromes type I and II, but HRS-AKI (hepatorenal syndrome acute kidney injury) or HRS-NAKI (that is, non-AKI). The HRS-AKI is mostly treated by terlipressin plus albumin as a bridging therapy until liver transplantation.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1861-9681
• Sprache: Deutsch