The Pathogenetic Mechanism of the Hepatorenal Syndrome The Pathogenetic Mechanism of the Hepatorenal Syndrome

Flowchart

Pathogenetic mechanisms of hepatorenal syndrome Pathogenetic mechanisms of hepatorenal syndrome Hemodynamic alterations
(portal hypertension, peripheral vasodilatation,
relatively low cardiac output, reduced effective blood volume) Hemodynamic alterations (portal hypertension, peripheral vasodilatation, relatively low cardiac output, reduced effective blood volume) Bleeding, paracentesis
without albumin Bleeding, paracentesis without albumin Bacterial infections, SBP Bacterial infections, SBP Hemodynamic alterations
(portal hypertension, peripheral vasodilatation,
relatively low cardiac output, reduced effective blood volume) Hemodynamic alterations (portal hypertension, peripheral vasodilatation, relatively low cardiac output, reduced effective blood volume) Hemodynamic alterations
(portal hypertension, peripheral vasodilatation,
relatively low cardiac output, reduced effective blood volume)

Hemodynamic alterations (portal hypertension, peripheral vasodilatation, relatively low cardiac output, reduced effective blood volume) Bleeding, paracentesis
without albumin Bleeding, paracentesis without albumin Bleeding, paracentesis
without albumin
Bleeding, paracentesis without albumin Bacterial infections, SBP Bacterial infections, SBP Bacterial infections, SBP Bacterial infections, SBP Hemodynamic alterations
(portal hypertension, peripheral vasodilatation,
relatively low cardiac output, reduced effective blood volume) Hemodynamic alterations
(portal hypertension, peripheral vasodilatation,
relatively low cardiac output, reduced effective blood volume)

Neurohumoral dysregulation
(activation of RAAS, SNS, vasopressin) Neurohumoral dysregulation
(activation of RAAS, SNS, vasopressin)
Effects on renal function
(renal vasoconstriction, retention of Na⁺ and H₂O) Effects on renal function
(renal vasoconstriction, retention of Na⁺ and H₂O)
⁺ ₂ Ascites Ascites Hepatorenal syndrome Hepatorenal syndrome Bleeding, paracentesis
without albumin Bleeding, paracentesis
without albumin
Bacterial infections, SBP Bacterial infections, SBP