ririРаны и раневые инфекции. Журнал имени проф. Б.М. КостючёнкаWounds and wound infections. The prof. B.M. Kostyuchenok journal2408-96132500-0594Regional non-governmental organization “Surgical society - Wounds and wound infections”10.17650/2408-9613-2017-4-2-6-11riri-124Research ArticleОБЗОРЫ, ЛЕКЦИИ, ИСТОРИЯ РАН И РАНЕВЫХ ИНФЕКЦИЙREVIEWS, LECTURES, HISTORY OF WOUNDS AND WOUND INFECTIONSДиагностические критерии гепаторенального синдрома и современные методы терапии (обзор литературы)Diagnostic criteria of hepatorenal syndrome and modern methods of therapy (literature review)НагимуллинР. Р.NagimullinR. R.

Контактное лицо: Рамиль Раисович Нагимуллин

420012, г. Казань, ул. Бутлерова, д. 49.

edem_balasi@bk.ruУстимовД. Ю.UstimovD. Y.

420012, г. Казань, ул. Бутлерова, д. 49

ДавыдоваВ. Р.DavidovaV. R.

420012, г. Казань, ул. Бутлерова, д. 49

ШипулинФ. А.ShipuF. linF. A.

420012, г. Казань, ул. Бутлерова, д. 49

ФГБОУ ВО «Казанский государственный медицинский университет» МЗ РФ; ГАУЗ «Городская клиническая больница № 7» МЗ РТРоссияKazan state medical university; City Clinical hospital №7Russian FederationФГБОУ ВО «Казанский государственный медицинский университет» МЗ РФ; ГАУЗ «Городская клиническая больница № 7» МЗ РТРоссияKazan state medical university; City Clinical hospital №7Russian FederationФГБОУ ВО «Казанский государственный медицинский университет» МЗ РФРоссияKazan state medical universityRussian Federation20171505201842611Copyright © Нагимуллин Р.Р., Устимов Д.Ю., Давыдова В.Р., Шипулин Ф.А., 20182018Нагимуллин Р.Р., Устимов Д.Ю., Давыдова В.Р., Шипулин Ф.А.Nagimullin R.R., Ustimov D.Y., Davidova V.R., ShipuF. lin F.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.riri.su/jour/article/view/124

Гепаторенальный синдром (HRS) является вариантом функциональной почечной недостаточности при острой или хронической патологии печени. При HRS 1 типа почечная функция ухудшается за несколько дней и без трансплантации печени 95,0 % пациентов умирают в течение ближайших недель. При HRS 2 типа функция почек остается на стабильном уровне либо наблюдается постепенное ее снижение на протяжении нескольких месяцев. Диагноз HRS основан на исключении других причин почечной недостаточности. Патофизиологические изменения при почечной недостаточности в случае HRS достаточно сложны – они включают в себя увеличение синтеза вазоактивных веществ, которые приводят к уменьшению почечной перфузии, снижению сопротивления в периферическом артериовенозном соустье, развитию портальной гипертензии, асциту, снижению коллоидно-осмотического давления и последовательно возрастающей задержке почками натрия и воды. Терапия HRS основана на коррекции кислотно-щелочного баланса и анемии, внутривенном введении альбумина, парацентезе, удалении нефротоксических агентов, а заместительная почечная терапия – это только симптоматическая мера.

Hepatorenal syndrome (HRS) is a variant of functional renal failure in acute or chronic liver pathology. Type 1 HRS entails a rapidly progressive decline in kidney function within few days and without liver transplantation, 95,0 % of patients die within the next few weeks. With type 2 HRS, kidney function remains stable or gradually declining over several months. HRS diagnosis is based on the exclusion of other causes of renal failure. Pathophysiological changes in renal failure in the case of HRS are quite complex – they include an increase in the synthesis of vasoactive substances, which lead to a decrease in renal perfusion, a decrease in resistance in peripheral arteriovenous anastomosis, the development of portal hypertension, ascites, a decrease in colloidal osmotic pressure and a consistently increasing delay of sodium and water in the kidneys. HRS therapy is based on acid-base balance and anemia correction, intravenous administration of albumin, paracentesis, the removal of nephrotoxic agents and the renal replacement therapy is only symptomatic.

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The authors declare that there are no conflicts of interest present.