Seeing and Sensing the Hepatorenal Syndrome (HRS): The Growing Role of Ultrasound-Based Techniques as Non-Invasive Tools for the Diagnosis of HRS

• Published in: Diagnostics (Basel) Vol. 14; no. 9; p. 938
• Main Authors: Tăluță, Cornelia, Ștefănescu, Horia, Crișan, Dana
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01-05-2024
• Subjects: acute kidney injury; Ascites; Bacterial infections; Biomarkers; cirrhosis; Creatinine; Cytokines; Diuretics; Drugs; Hemodynamics; hepatorenal syndrome; Inflammation; Injuries; Kidney diseases; Liver; Liver cirrhosis; Liver diseases; Methods; Mortality; Pathophysiology; Point of care testing; Prognosis; shear wave elastography; Ultrasonic imaging; urinary biomarkers; urinary biomarkers; acute kidney injury; cirrhosis; hepatorenal syndrome; shear wave elastography
• ISSN: 2075-4418; 2075-4418
• DOI: 10.3390/diagnostics14090938

More than half of patients hospitalized with liver cirrhosis are dealing with an episode of acute kidney injury; the most severe pattern is hepatorenal syndrome due to its negative prognosis. The main physiopathology mechanisms involve renal vasoconstriction and systemic inflammation. During the last decade, the definition of hepatorenal syndrome changed, but the validated criteria of diagnosis are still based on the serum creatinine level, which is a biomarker with multiple limitations. This is the reason why novel serum and urinary biomarkers have been intensively studied in recent years. Meanwhile, the imaging studies that use shear wave elastography are using renal stiffness as a surrogate for an early diagnosis. In this article, we focus on the physiopathology definition and highlight the novel tools used in the diagnosis of hepatorenal syndrome.