Wilde B, Canbay A, Katsounas A. Clinical and pathophysiological understanding of the hepatorenal syndrome: Still wrong or still not exactly right? World J Clin Cases 2023; 11(6): 1261-1266 [PMID: 36926126 DOI: 10.12998/wjcc.v11.i6.1261]
Corresponding Author of This Article
Antonios Katsounas, MD, PhD, Deputy Director, Doctor, Professor, Department of Medicine, Ruhr University Bochum, Universitätsklinikum Knappschaftskrankenhaus Bochum GmbH In der Schornau 23-25, Bochum 44892, Germany. antonios.katsounas@kk-bochum.de
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Feb 26, 2023; 11(6): 1261-1266 Published online Feb 26, 2023. doi: 10.12998/wjcc.v11.i6.1261
Clinical and pathophysiological understanding of the hepatorenal syndrome: Still wrong or still not exactly right?
Benjamin Wilde, Ali Canbay, Antonios Katsounas
Benjamin Wilde, Department of Nephrology, University of Duisburg-Essen, University Hospital Essen, Essen 45147, Germany
Ali Canbay, Antonios Katsounas, Department of Medicine, Ruhr University Bochum, Bochum 44892, Germany
Author contributions: Wilde B performed the majority of the writing and performed research of scientific literature; Canbay A prepared the figure and performed research of scientific literature; Katsounas A designed the outline, performed research of scientific literature, coordinated the writing and performed final editing.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Antonios Katsounas, MD, PhD, Deputy Director, Doctor, Professor, Department of Medicine, Ruhr University Bochum, Universitätsklinikum Knappschaftskrankenhaus Bochum GmbH In der Schornau 23-25, Bochum 44892, Germany. antonios.katsounas@kk-bochum.de
Received: October 16, 2022 Peer-review started: October 16, 2022 First decision: November 26, 2022 Revised: December 15, 2022 Accepted: February 3, 2023 Article in press: February 3, 2023 Published online: February 26, 2023
Abstract
The hepatorenal syndrome (HRS) is one major extrahepatic complication of end-stage liver diseases. While circulatory dysregulation is considered as primary etiology for HRS, cirrhosis-related (systemic) inflammation and/or cardial dysfunction may also play a key pathogenic role in HRS development. Exclusion of other causes of acute kidney injury (AKI) is required for diagnosis of HRS-AKI by the definition of the International Club of Ascites. However, the pathophysiology of HRS is not understood completely and there are still limited therapeutic options. Reversibility of renal dysfunction after liver transplantation indicates that HRS-AKI is a functional disorder caused by altered cellular function. The interplay between systemic inflammation and the onset of kidney-related hypometabolism may have a key role and needs to be studied in depth. This minireview challenges simplified views of the HRS in the context of diagnostics and therapy stressing the need for further evidence to advance the knowledge on this syndrome.
Core Tip: This minireview challenges simplified views of the hepatorenal syndrome in the context of diagnostics and therapy stressing the need for further evidence to advance the knowledge on this syndrome.
