Hepatorenal Syndrome In Nigeria: A Review of Pathophysiology, Clinical Features and Management

Abstract

Hepatorenal syndrome (HRS), a functional renal failure in patients with advanced chronic liver disease (CLD), cirrhosis or fulminant hepatic failure, in the absence of clinical or laboratory evidence of intrinsic renal disease is a common cause of admission into the intensive care unit. Despite the preponderance of CLD in our environment, HRS is rarely reported with sparse (if any) literature in our setting. In this review we discussed the definition, suggested aetiopathogenesis, clinical features and management. We reviewed cases of HRS managed in our centre and found that type 1, which is the more severe is common mainly because of late presentation and that majority of the patients did not benefit from renal replacement therapy because of haemodynamic instability. The review espoused the horrendous mortality associated with HRS particularly in the absence of liver transplantation and calls for urgent steps to set up liver transplantation units in our country as well as manpower training which will assist in arresting the mortality on a short term. On a long term however, there is the need for community prevention of CLD through mass vaccination against Hepatitis B and C as well as health education on deleterious socio-cultural practices. IFEMED Journal Vol. 14 (1) 2008: pp. 29-34