There are two types of hepatorenal syndrome:
- Type 1 (Acute) involves a rapid decline in kidney function and can quickly progress to life-threatening kidney failure. Your kidneys, which are part of your urinary tract, perform a number of vital functions, including filtering your blood to remove waste and extra fluid from your body. Signs of declining kidney function may include a significant reduction in urination; confusion; swelling caused by the buildup of fluid between tissues and organs (a condition known as edema) and abnormally high levels of nitrogen-rich, body-waste compounds in the blood (a condition known as azotemia).
- Type II involves a more-gradual decrease in kidney function. Type II often leads to an abnormal buildup of fluid in the abdomen (ascites) that is resistant to treatment with diuretics. Sometimes referred to as water pills, diuretics can help rid your body of salt (sodium) and water and lower your blood pressure. People diagnosed with HRS Type II have a longer median survival time than those with Type I.
Causes of Hepatorenal Syndrome
Although HRS can occur in people with advanced liver disease, its exact cause and rate of occurrence are still unknown.
The hallmark of the syndrome is significant narrowing (constriction) of the blood vessels that feed the kidneys. When blood flow to the kidneys is restricted, kidney function declines over time. The exact cause of constriction of the blood vessels feeding the kidneys remains unknown, but some researchers believe it may result from a combination of factors, including high pressure within the portal vein (portal hypertension), which carries blood from the digestive organs to the liver. The most-common cause of portal hypertension is cirrhosis of the liver.
There are various theories on the cause of HRS. The most common theory is that HRS is caused by a narrowing of the blood vessels that feed the kidneys, resulting in reduced blood flow to the kidneys and declining kidney function over time.
Researchers have also identified certain “triggers” that can make it more likely for people with liver disease to develop HRS. Spontaneous bacterial peritonitis (SBP) is the most common of these triggers. SBP is a complication of cirrhosis and ascites. It is an infection of the membrane lining the abdominal cavity. Another cause is too many diuretics (pills that promote urination).
Prevention of Hepatorenal Syndrome
- Avoid nonsteroidal anti-inflammatory drugs (NSAIDs). These include aspirin, ibuprofen (Advil, Motrin, etc.), naproxen (e.g., Aleve), and many other generic and brand name drugs
- Avoid contrast dyes used for certain medical tests such as MRIs and CT scans, and
Don’t drink excessive amounts of alcohol
Symptoms of Hepatorenal Syndrome
HRS has a variety of nonspecific symptoms, including:
- Fatigue
- Abdominal pain
- A general feeling of illness (or malaise)
People with HRS may also have symptoms related to advanced liver disease, including:
- A yellow tint to the skin or eyes caused by an excess of bilirubin in the blood (jaundice)
- An abnormal buildup of fluid in the abdomen (ascites)
- An enlarged spleen (splenomegaly)
A temporary worsening of brain function (confusion and/or memory loss) related to hepatic encephalopathy
HOMOEOPATHIC TREATMENT OF HEPATORENAL SYNGROME
BRYONIA ALBA – Bryonia is a medicine indicated in a condition when stitching pains are present in the region of right abdomen in right hypochondrium get worse from slightest motion and better by rest, lying on right side. There is dryness of mucus membrane is also marked. The liver is swollen, congested and inflamed. There is marked thirst for large quantity of water is the main symptom of Bryonia. Along with it, vomiting of bile and water immediately after eating, especially warm drinks, which are immediately vomited out. There is a marked constipation, stools are hard, dry, black as if burnt; seem too large.
MERCURIUS – Mercurius is a medicine used in cirrhosis of the liver with dull pain and sensitive to touch over the region of the liver. Sensitiveness is so marked that the patient is unable to lie down on the right side. Enlargement of the liver is also present with slow digestion. Jaundice is also covered by Mercurius in which the skin and conjunctiva changes to yellow coloured. Great thirst for cold drinks is also present. The stools are not normal, colour changes to, either clay-coloured or yellowish-green stools accompanied with a great pain and unsatisfactory stool. Mercurius has particular yellowish white coated tongue with imprint of the teeth. All complaints of Mercurius get aggravated at night, from warmth of bed, from damp, cold, rainy weather, and during perspiration.
CHELIDONIUM MAJUS – It is one of the remedies predominantly act on the liver, mainly jaundice and fatty liver. It is mainly right sided medicine. There is a stitching pain with soreness in the liver and spleen which radiate to back, under the angle of the right shoulder blade, which may further extend to the chest, stomach, or hypochondrium. Right and may be on left side of abdomen (hypochondrium) are painful on slight pressure. Liver is swollen white chilliness, yellow discolouration of eyes and the skin with fever. Great desire for acids and sour things like pickles. Nausea is also present along with sensation of heat in stomach. All complaints relieved after dinner.
DIGITALIS – Digitalis can be thought of when jaundice arises from cardiac diseases. In Digitalis, the person experience drowsiness, semi-consciousness with soreness and crushing pain in the region of the liver. All food tastes bitter. In cases of severe cases of jaundice, Digitalis is used when the pulse become irregular, more frequent and intermittent. There is rapid decline of all the strength of the body. There is shooting and tearing colic, with desire to vomit, more during movement and expiration. Passes stool of white colour like chalk, or the ashy stool.
MYRICA CERIFERA - Myrica is an important remedy in affections of the liver. There is dull pain in region of the liver with feeling of fulness. Jaundice is also treated by Myrica, when there is weakness, prostration with clay-coloured stools and loss of appetite. There is spasmodic and pulsating pain with a desire to pass stool but only passes a flatus which is offensive and passes flatus while walking. All complaints increase from warmth of bed at night, after disturbed sleep and better after breakfast, and in open air.
