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Early Recognition and Treatment of Hepatorenal Syndrome
- Recognize hepatorenal syndrome early using updated AKI criteria for prompt treatment.
- Initiate vasopressor therapy to increase renal perfusion pressure and use albumin to improve circulating volume.
Vasopressor Use in Hepatorenal Syndrome
- Use vasopressors promptly in hepatorenal syndrome to improve kidney blood flow.
- Norepinephrine is commonly used; terlipressin is preferred but unavailable in US, while midodrine and octreotide have limited evidence.
Renal Replacement in Hepatorenal Syndrome
- Renal replacement therapy does not reverse hepatorenal syndrome.
- Use renal replacement therapy only as a bridge for hepatorenal syndrome patients eligible for liver transplantation.