REBOOT #145 Hepatorenal Syndrome

Tackle the complex pathophysiology, diagnosis, and management of hepatorenal syndrome in this Curbsiders classic from #NephMadness 2019 featuring @kidney_boy Joel Topf, HRS expert Juan Carlos Velez (@veleznephhepato), and self-proclaimed most-handsome-nephrologist Bill Whittier (@TWhittier_RUSH) episode! Topics: hepatorenal physiology, renal ultrasound, urine electrolytes, terlipressin, norepinephrine, midodrine and octreotide, albumin challenge, crystalloids vs colloids, and more! Original show notes here.
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Credits

• Written and produced by: Justin Berk MD, Nora Taranto MD
• Infographic by: Alex M @nephroguy
• Host: Matthew Watto MD
• Edited by: Matthew Watto MD (audio), Emi Okamoto MD (written materials)
• Guests: Joel Topf MD, Juan Carlos Velez MD, Bill Whittier MD
  
  

Show Segments

• NephMadness Kidney Pun Contest
• Disclaimer
• Intro, guest one-liners
• Case of acute kidney injury in a patient with cirrhosis
• Initial differential diagnosis and approach to newly elevated creatinine in cirrhosis (urinalysis, FeNa, urine sodium)
• History and physical in cirrhosis and AKI
• Fluid choice
• Diuretic therapy in cirrhosis and volume overload
• Is a Renal Ultrasound useful in AKI?
• Recap: the initial approach to AKI in cirrhosis
• Therapeutic trials when volume status is uncertain
• Hepatorenal physiology revisited
• Vasoconstrictor therapy with octreotide, terlipressin, or norepinephrine
• Type 1 versus type 2 hepatorenal syndrome
• Large-volume paracentesis (LVP) in cirrhosis with AKI; how much fluid to remove; use of diuretics or LVP in patients on norepinephrine?!
• Diagnostic criteria or HRS
• NephMadness matchups including bile cast nephropathy
• Outro

Sponsors 

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