Type 1 Hepatorenal Syndrome
What is Type 1 Hepatorenal Syndrome?
Type 1 Hepatorenal Syndrome (HRS-1) is a life-threatening disorder that occurs in people with cirrhosis of the liver, when there is rapid deterioration in kidney function. It is characterized by a rapid decline in the glomerular filtration rate (GFR), leading to vascular collapse and potentially death if not promptly treated. The most common form of HRS involves acute renal failure that develops over a few days or weeks, leading to increased levels of urea and creatinine in the blood. In some cases, the damage may be reversible, but in other cases can be permanent.
Symptoms of Type 1 Hepatorenal Syndrome
The symptoms of type 1 HRS are similar to those of kidney failure, regardless of the cause. These include:
- swelling of the legs and feet
- abdominal pain
- nausea, vomiting, and a poor appetite
- dark urine
- tiredness and confusion
- easy bruising and excessive bleeding
Diagnosis of Type 1 Hepatorenal Syndrome
In order to diagnose type 1 HRS, the doctor will take a detailed history, including information about underlying health conditions such as cirrhosis, and then order tests to check for evidence of kidney failure. These tests may include a urinalysis, which can show decreased creatinine clearance and increased urea levels in the blood. Blood tests may also be ordered to check for elevated creatinine levels.
Treatment of Type 1 Hepatorenal Syndrome
Treatment of type 1 HRS is aimed at restoring normal kidney function. This may involve the use of medications such as diuretics or antibiotics, lifestyle changes such as drinking more fluids and avoiding alcohol consumption, as well as other treatments such as dialysis or transplantation. In some cases, surgery may be recommended to remove a portion of the damaged liver, which can improve kidney function.
Prognosis for Type 1 Hepatorenal Syndrome
If treatment is started quickly enough, the prognosis for type 1 HRS is usually good. Early diagnosis and intervention can prevent long-term damage to the kidneys and can restore normal kidney function in some cases. However, if treatment is not started early, permanent damage to the kidneys may occur.