Hepato Renal syndrome is a severe condition usually occurring in chronic liver disease patient. Actually Hepato Renal syndrome occurs at the very end stage of chronic liver disease and the mortality rate of the patients, when hepato renal syndrome developed is very high. In short we can describe hepato renal syndrome as detoriation of the renal function at the late statage of chronic liver disease or fulminant liver failure.
Mechanism of Hepato Renal Syndrome (HRS) development:
The actual mechanism of the development of hepato renal syndrome is not so clear. It is thought that multiple factors play role inn the development of hepato renall syndrome. Constriction of the renal blood veasels is the main of them. Why the constriction of the renal blood vessels occur? The answer is not so clear. It is believed that activation of systemic vaso constrictor agents and the inactivation of the systemic vaso dilator agents are responsible for this. Though the renal blood vessels are constricted, there are no changes are seen in renal parenchyma.
The histological findings of the renal parenchyma appears to be normal where the histological picture of liver shows total loss of normal architecture.
In hepato renal syndrome there is a complete inverse relationship is seen between renal plasma flow and glomerular filtration rate. Though renal plasma flow is decreased, Glomerular filtration rate is still increasing. This is may be due to a very minimal and microscopic damage to glomerular basement membrane.
