Unfortunately as the liver fails the kidneys may also begin to fail along with the liver. Many liver transplant patients have this happen during their long wait times on transplant waiting lists at many of the largest transplant center in the country. The good news is the kidneys will usually bounce back after a liver transplant and have as good outcomes as those patients who underwent transplantation without being treated for HRS. Some whose kidneys become too damaged need a liver and kidney transplant to recover their health again.
There are types of hepatorenal syndrome (HRS):
Type I shows a rapidly progressive reduction in renal function as defined by a doubling of the initial serum creatinine to a level greater that 2.5 mg/dL or a 50% reduction of the initial 24-hour creatinine clearance to a level lower that 20 mL per minute in less than 2 weeks.
Type II does not have a rapidly progressive course and is a commonly associated with poor outcome for patients.
Terlipressin has become the most studied drugs for HRS. It can be used in conjunction with albumin for improvement in kidney function in patients with type 1 HRS. It may take several days, and although recurrent HRS after treatment discontinuation is uncommon, a repeat course of terlipressin with albumin is usually effective.
Be well.
Hector
Hi. Thank you for all your information. Unfortunately I had to fly home because my dads kidney function started to deteriorate even with the Terlipressin and albumin. He has had numerous blood transfusions but they are struggling to keep the canulas in his body as his tissues are so swollen and oedemic. He has started vomiting and I spoke to his doctor who said he may only have a week or so. Last night he couldn't tolerate any of his meds and I feel now that he truly has had enough. The hardest part for me is how truly ill he must feel and I can't do anything to help.
This disease is terrible not only for the patients but for the families dealing with it.
Thank you for your help.
Best wishes
MJ
Hi.
Just to say thank you for all your help and support but sadly my dad passed away on Father's day. He had HRS and was extremely sick. He did manage to get home to spend his last few days with his family. He passed away very peacefully but it's still a shock to lose your dad to such a terrible illness. X
I'm so very sorry that you lost your dad. I'm happy tho that you were able to spend some peaceful time with him. Yes, it's a horrible disease but imagine your dad had a very meaningful life. He obviously had a wonderful child that was able to be with him as well as family.
Try to remember the special times together.
.....Kim