Talk:Hepatorenal syndrome

message: The article cited in reference 9 states that subjects in group B, those with acites and functional renal failure, have decreased renal and femoral cardiac output fractions, in contrast to what is written in the pathophys section of this article. What is the basis for this discrepency?  —Preceding unsigned comment added by 130.91.98.31 (talk) 03:57, 22 June 2008 (UTC)
thread_title: Pathophysiology accuracy?

message: This was definately clear, well-referenced, and approachable from someone like me, who doesn't know anything about the subject. Great work! Dlmccaslin 18:24, 11 August 2006 (UTC)
thread_title: Good Article

message: I haven't heard hepatorenal syndrome referred to as hepatorenal failure.  eMedicine does not give hepatorenal failure as a synonym nor does Stedman's medical dictionary.  Hepatorenal failure is not a precise term for the condition -- and the following ref. suggests it is not used, as hepatic and renal failure can occur simulateously for a number of different reasons. Davison AM. Hepatorenal failure. Nephrol Dial Transplant. 1996;11 Suppl 8:24-31. Review.  Nephron  T|C 19:31, 9 September 2006 (UTC)
replies: text: Agreed.  Hepatorenal syndrome is a distinct definition -- Samir धर्म 01:28, 10 September 2006 (UTC)
thread_title:  ''Hepatorenal failure'' 

message: The trials are lousy. JFW | T@lk 20:13, 6 March 2007 (UTC)
replies: text: So's the prognosis, my friend, unfortunately with or without therapy -- Samir 06:44, 26 May 2007 (UTC)
thread_title:  Trials 

message: *does not fulfill WP:LEAD
*no images
*The section on history is limited.  When did the first case occur.
*How common is this condition?
*What are the causes?
--Doc James (talk · contribs · email) 01:32, 21 May 2009 (UTC)
thread_title: GA status

message: - higher bilirubin and poorer BP response to albumin + terlipressin predicts treatment failure. JFW | T@lk 14:03, 25 December 2009 (UTC)
thread_title:  Predictors of response 

message: An international committee has met to try to align the definitions of HRS with the new AKI classification for acute kidney injury. The result is this document: doi:10.1136/gut.2010.236133. It will probably need mentioning, especially if this becomes widely used. JFW | T@lk 11:04, 4 April 2011 (UTC)
replies: text: I hadn't seen doi:10.1186/cc11188, a new ADQI consensus document on HRS. This needs to be mentioned. Particularly interesting is the paucity of good evidence, and the advice to withhold RRT if someone with HRS is not a transplant candidate. JFW | T@lk 13:23, 29 October 2012 (UTC)
thread_title:  All change 

message: "Complications of TIPS for treatment of HRS include the worsening of hepatic encephalopathy (as the procedure involves the forced creation of a porto-systemic shunt, effectively bypassing the ability of the liver to clear toxins)"
:I think there's no question that TIPS can worsen encephalopathy, but there is no support in the literature for the mechanism implied parenthetically here, that the liver's failure to 'clear' 'toxins' results in encephalopathy.  What toxin is that?  By what mechanism does the liver 'clear' it?  How does TIPS result in a failure of this mechanism?  Researchers, myself among them - sacrificed dozens of portal-shunted rats, ill-tempered bastards all - have been investigating these questions for 50+ years and there is no consensus about the answers; most of us feel that there is in fact no endogenous toxin responsible for HE.  The cited references are careful not to claim any such mechanism, by the way. 99.127.139.233 (talk) 18:07, 7 August 2011 (UTC)
replies: text: Many clinical papers seem to accept the ammonia hypothesis as fact, and indeed there is good basic scientific data on radiolabeled ammonia concentrating in the brain. Bypassing the liver (and thus the urea cycle enzymes) does certainly seem to be the mechanism of HE following iatrogenic shunting. JFW | T@lk 13:31, 29 October 2012 (UTC)
thread_title:  TIPS(S) and encephalopathy