Acute kidney injury (AKI) is an important marker of morbidity and mortality in critically ill cirrhotic patients. The most common causes of AKI in cirrhotic patients include prerenal or hepatorenal syndrome (HRS). Diagnosis of AKI may be delayed by the lack of clinical, biochemical, and radiological markers with proven sensitivity and specificity in cirrhotic patients. In this review, we discus...

mellitus with a weight loss of 14 kg over 3 months. His history was unremarkably and included a pacemaker implantation 2 years before, without laboratory abnormalities. Because the islet-cell antibodies were

The hyperdynamic syndrome is a late consequence of portal hypertension in cirrhosis. The principal hemodynamic manifestations of the hyperdynamic syndrome are high cardiac output, and increased heart rate and total blood volume, accompanied by reduced total systemic vascular resistance. Pathophysiology involves a complex of humoral and neural mechanisms that can determine hemodynamic changes, a...

OBJECTIVES To analyze the predisposing factors, modifications of vasoactive systems, and prognosis of patients with cirrhosis and hyponatremia. PATIENTS AND METHODS Fifty-four patients with hyponatremia (serum sodium level of <130 mEq/L after 5 days of hyponatremic diet and no diuretic therapy). Twenty cirrhotic patients served as controls. We measured plasma renin activity and levels of plas...

I read the article “Hepatorenal syndrome: an update” in São Paulo Med J with great interest. When I published a small study in 1996 with favorable results from the use of relatively small doses of BQ123 in severely affected patients, I tried unsuccessfully to attract commercial interest to pursue the investigation. The physiological effects of ET-1 in healthy volunteers in Rabelink’s study seem...