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SINDROMUL HEPATORENAL

SINDROMUL HEPATORENAL

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Published by: andreea-tania on Aug 09, 2009
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02/05/2013

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Sindrom hepatorenal
 
Definitie/clasificare
SHR – dezvoltarea IR la pacienti cu afectarehepatica severa (ac/cr) in absenta oricareipatologii renale identificabileSHR tip I – dezvoltarea acuta a insuficienteirenale (dublarea creatininei serice la un nivelmai mare de 225 µM sau scaderea cu 50% aclearance creatininei pana sub 20 ml/min intr-uninterval de 2 saptamaniSHR tip II – dezvoltare cronica, lenta ainsuficientei renale (apare in general la ascitelerezistente la diuretice)
 
Criterii de diagnostic
Criterii majoreAfectare hepatica acuta sau cronica cu insuficientahepatica avansata si hipertensiune portalaFiltrare glomerulara scazuta demonstrata de o creatininaserica peste 225 µM (2,5 mg/dl) sau un clearance lacreatinina sub 40 ml/min.Absenta socului, infectiilor bacteriene, tratamentului cudroguri nefrotoxice, pierderilor masive de fluide (inclusivHDS)Absenta imbunatatirii diurezei dupa perfuzia cu 1,5 lsolutie salina isotonaProteinurie sub 0,5 g/zi si absenta leziunilor renale laexamenul echografic

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