Hepatorenal Syndrome
Lypressin
Paracentesis
Hepatitis, Alcoholic
Felypressin
Peritoneovenous Shunt
Albumins
Liver Cirrhosis
Portasystemic Shunt, Transjugular Intrahepatic
Liver Transplantation
Liver Failure
Acute Kidney Injury
Hypertension, Portal
Tyrosinemias
Kidney
Encyclopedias as Topic
Liver Failure, Acute
Review article: pharmacological treatment of the hepatorenal syndrome in cirrhotic patients. (1/89)
Renal failure is common in patients who are dying from end-stage cirrhosis, developing in 40-80% of all patients. Where there is no anatomical or pathological cause for the renal failure, it is termed the hepatorenal syndrome. When the hepatorenal syndrome develops, it will only recover when there is some degree of improvement in liver function. Thus for most patients this will occur only after liver transplantation, although the transplantation mortality is increased in this group. Hepatorenal syndrome is a common complication of alcoholic hepatitis, and this group is unusual in that with time and abstinence, significant recovery of liver function may occur. There is therefore a need for supportive therapy to allow time for some recovery of liver function in patients with alcoholic hepatitis and hepatorenal syndrome. Similarly, patients may need support whilst waiting for liver transplantation. This article reviews the pathophysiology and treatment of hepatorenal syndrome. (+info)Improvement of hepatorenal syndrome with extracorporeal albumin dialysis MARS: results of a prospective, randomized, controlled clinical trial. (2/89)
In hepatorenal syndrome (HRS), renal insufficiency is often progressive, and the prognosis is extremely poor under standard medical therapy. The molecular adsorbent recirculating system (MARS) is a modified dialysis method using an albumin-containing dialysate that is recirculated and perfused online through charcoal and anion-exchanger columns. MARS enables the selective removal of albumin-bound substances. A prospective controlled trial was performed to determine the effect of MARS treatment on 30-day survival in patients with type I HRS at high risk (bilirubin level, > or =15 mg/dL) compared with standard treatment. Thirteen patients with cirrhosis with type I HRS were included from 1997 to 1999. All were Child's class C, with Child-Turcotte-Pugh scores of 12.4 +/- 1. 0, United Network for Organ Sharing status 2A, and total bilirubin values of 25.7 +/- 14.0 mg/dL. Eight patients were treated with the MARS method in addition to hemodiafiltration (HDF) and standard medical therapy, and 5 patients were in the control group (HDF and standard medical treatment alone). None of these patients underwent liver transplantation or received a transjugular intrahepatic portosystemic shunt or vasopressin analogues during the observation period. In the MARS group, 5.2 +/- 3.6 treatments (range, 1 to 10 treatments) were performed for 6 to 8 hours daily per patient. A significant decrease in bilirubin and creatinine levels (P <.01) and increase in serum sodium level and prothrombin activity (P <.01) were observed in the MARS group. Mortality rates were 100% in the control group at day 7 and 62.5% in the MARS group at day 7 and 75% at day 30, respectively (P <.01). We conclude that the removal of albumin-bound substances with the MARS method can contribute to the treatment of type I HRS. (+info)Long term outcome after transjugular intrahepatic portosystemic stent-shunt in non-transplant cirrhotics with hepatorenal syndrome: a phase II study. (3/89)
BACKGROUND: Recent small studies on hepatorenal syndrome (HRS) indicate some clinical benefit after transjugular intrahepatic portosystemic stent-shunt (TIPS) but sufficient long term data are lacking. AIM: We studied prospectively feasibility, safety, and long term survival after TIPS in 41 non-transplantable cirrhotics with HRS (phase II study). PATIENTS AND METHODS: HRS was diagnosed using current criteria (severe (type I) HRS, n=21; moderate (type II) HRS, n=20). Thirty one patients (14 type I, 17 type II) received TIPS (8-10 mm) while advanced liver failure excluded shunting in 10. During follow up (median 24 months) we analysed renal function and survival (Kaplan-Meier). RESULTS: TIPS markedly reduced the portal pressure gradient (21 (5) to 13 (4) mm Hg (mean (SD)); p<0.001) with one procedure related death (3.2%). Renal function deteriorated without TIPS but improved (p<0.001) within two weeks after TIPS (creatinine clearance 18 (15) to 48 (42) ml/min; sodium excretion 9 (16) to 77 (78) mmol/24 hours) and stabilised thereafter. Following TIPS, three, six, 12, and 18 month survival rates were 81%, 71%, 48%, and 35%, respectively. As only 10% of non-shunted patients survived three months, total survival rates were 63%, 56%, 39%, and 29%, respectively. Multivariate Cox regression analysis revealed bilirubin (p<0.001) and HRS type (p<0.05) as independent survival predictors after TIPS. CONCLUSIONS: TIPS provides long term renal function and probably survival benefits in the majority of non-transplantable cirrhotics with HRS. These data warrant controlled trials evaluating TIPS in the management of HRS. (+info)Alcoholic hepatitis-the case for intensive management. (4/89)
Alcoholic hepatitis is a common condition with a high mortality. Although treatment options for established alcoholic hepatitis are limited, many of the complications of this condition are preventable. This case report and discussion illustrate the important role of early diagnosis and intervention in this patient group. Important management points are stressed to aid physicians who may encounter this condition rarely. (+info)Microcomputed tomography of kidneys following chronic bile duct ligation. (5/89)
BACKGROUND: In hepatic cirrhosis, renal sodium and water retention can occur prior to decreases in renal blood flow (RBF). This may be explained in part by redistribution of the intrarenal microcirculation toward the juxtamedullary nephrons. To appreciate this three-dimensional spatial redistribution better, we examined the intrarenal microcirculatory changes using microcomputed tomography (micro-CT) in rats subjected to chronic bile duct ligation (CBDL). METHODS: Six kidneys from control rats and eight kidneys from rats that had undergone CBDL for 21 days were perfusion fixed in situ at physiological pressure, perfused with silicon-based Microfil containing lead chromate, embedded in plastic, and scanned by micro-CT. The microvasculature in the reconstructed three-dimensional renal images was studied using computerized image-analysis techniques. To determine the physiological condition of the rats, parallel experiments were conducted on six control and six CBDL rats to measure mean arterial pressure (MAP), RBF, glomerular filtration rate (GFR), urine flow (UF) rate, and sodium excretion by conventional methods. RESULTS: The percentage of vasculature in the renal cortex from CBDL rats was significantly decreased (10.8 +/- 0.4% vs. 16.8 +/- 2.7% control values). However, the vascular volume fractions of the medullary tissues were not significantly altered. There were no significant differences in the number of glomeruli between groups (36,430 +/- 1908 CBDLs, 36,609 +/- 3167 controls). The CBDL rats had a similar GFR than the controls but a reduced MAP, RBF, UF, and sodium excretion. CONCLUSIONS: The results indicate that after CBDL, there is a selective decrease in cortical vascular filling, which may contribute to the salt and water retention that accompanies cirrhosis. (+info)Pathogenesis of ascites in cirrhosis and portal hypertension. (6/89)
Disturbance of the circulatory system frequently occurs in patients with cirrhosis. Cardiac index and plasma volume increase whereas mean arterial blood pressure and systemic vascular resistance decrease. Marked disturbance in vasoconstrictor and natriuretic systems also exist with activation mediators such as plasma renin, plasma noradrenaline, antidiuretic hormone and endothelin. Renal factors contribute to the pathogenesis of ascites formation although the exact mechanisms are yet to be elucidated. Several theories exist in relation to pathogenesis although none to date fully explain all of the findings observed in clinical practice. In this review, we examine the mechanisms that contribute to the development of ascites in patients with cirrhosis and portal hypertension. (+info)Leptospirosis in the causation of hepato-renal syndrome in and around Pune. (7/89)
Fifty cases of hepato-renal dysfunction of unknown etiology were studied over a two-year period. Urine samples were examined microscopically and cultured for Leptospira. Serum samples were examined for antibodies against Leptospira by the Macroscopic slide agglutination test (MSAT). Seventeen out of fifty patients (34%) showed evidence of Leptospiral infection by at least two diagnostic techniques used. 15/17 i.e. 88.2% were positive by dark ground microscopy, 7/17 were diagnosed by culture technique and 16/17 i.e. 94% were confirmed by serology. There was a good correlation between Microscopic agglutination test (MAT) and MSAT. Thus Leptospires seem to play a major role in the causation of hepato-renal dysfunction in and around Pune, Maharashtra. (+info)Current management and novel therapeutic strategies for refractory ascites and hepatorenal syndrome. (8/89)
The circulatory disturbances seen in advanced cirrhosis lead to the development of ascites, which can become refractory to diet and medical therapy. These abnormalities may progress and cause a functional renal failure known as the hepatorenal syndrome. Management of refractory ascites and hepatorenal syndrome is a therapeutic challenge, and if appropriate, liver transplantation remains the best treatment. New therapeutic options have recently appeared, including the transjugular intrahepatic portosystemic shunt and selective splanchnic vasoconstrictor agents, which may improve renal function and act as a bridge to transplantation. (+info)Hepatorenal syndrome (HRS) is a serious complication that primarily affects people with advanced liver disease, particularly those with cirrhosis. It's characterized by functional renal failure in the absence of structural kidney damage. This means that the kidneys stop working properly, but if they were to be removed and examined, there would be no obvious physical reason for their failure.
The medical definition of hepatorenal syndrome includes specific diagnostic criteria:
1. Presence of liver cirrhosis or fulminant hepatic failure.
2. Evidence of impaired liver function, such as ascites (accumulation of fluid in the abdomen) and elevated levels of bilirubin in the blood.
3. Functional renal failure, defined as a serum creatinine level greater than 1.5 mg/dL or a doubling of the baseline creatinine to a level above 1.5 mg/dL in patients with previously normal renal function.
4. Absence of structural kidney damage, confirmed by a normal urinalysis (no protein or red blood cells in the urine), a high urine sodium concentration (greater than 10 mEq/L), and a low fractional excretion of sodium (less than 1%).
5. No alternative explanation for renal failure, such as sepsis, hypovolemia, or use of nephrotoxic medications.
Hepatorenal syndrome is further divided into two types:
- Type 1 HRS: This form is characterized by a rapid and severe decline in kidney function, with a doubling of the serum creatinine to a level greater than 2.5 mg/dL within two weeks. Type 1 HRS has a poor prognosis, with a median survival time of about two weeks if left untreated.
- Type 2 HRS: This form is characterized by a more gradual and modest decline in kidney function, with a serum creatinine level persistently above 1.5 mg/dL. Type 2 HRS has a better prognosis than type 1, but it still significantly worsens the overall survival of patients with liver cirrhosis.
Hepatorenal syndrome is a serious complication of liver cirrhosis and other forms of advanced liver disease. It requires prompt recognition and treatment to improve outcomes and prevent further deterioration of kidney function.
Lypressin is a synthetic analogue of a natural hormone called vasopressin, which is produced by the pituitary gland in the brain. The primary function of vasopressin, also known as antidiuretic hormone (ADH), is to regulate water balance in the body by controlling the amount of urine produced by the kidneys.
Lypressin has similar physiological effects to vasopressin and is used in medical treatments for conditions related to the regulation of water balance, such as diabetes insipidus. Diabetes insipidus is a condition characterized by excessive thirst and the production of large amounts of dilute urine due to a deficiency in vasopressin or an impaired response to it.
In summary, Lypressin is a synthetic form of vasopressin, a hormone that helps regulate water balance in the body by controlling urine production in the kidneys. It is used as a therapeutic agent for treating diabetes insipidus and related conditions.
Paracentesis is a medical procedure in which a thin needle or catheter is inserted through the abdominal wall to remove excess fluid from the peritoneal cavity. This procedure is also known as abdominal tap or paracentesis aspiration. The fluid removed, called ascites, can be analyzed for infection, malignant cells, or other signs of disease. Paracentesis may be performed to relieve symptoms caused by the buildup of excess fluid in the abdomen, such as pain, difficulty breathing, or loss of appetite. It is commonly used to diagnose and manage conditions such as liver cirrhosis, cancer, heart failure, and kidney failure.
Ascites is an abnormal accumulation of fluid in the peritoneal cavity, which is the space between the lining of the abdominal wall and the organs within it. This buildup of fluid can cause the belly to swell and become distended. Ascites can be caused by various medical conditions, including liver cirrhosis, cancer, heart failure, and kidney disease. The accumulation of fluid in the peritoneal cavity can lead to complications such as infection, reduced mobility, and difficulty breathing. Treatment for ascites depends on the underlying cause and may include diuretics, paracentesis (a procedure to remove excess fluid from the abdomen), or treatment of the underlying medical condition.
Alcoholic hepatitis is a medical condition characterized by inflammation and damage to the liver caused by excessive alcohol consumption. It is a type of hepatitis that specifically results from alcohol abuse, rather than from viral infections or other causes. The condition can vary in severity, and long-term heavy drinking increases the risk of developing alcoholic hepatitis.
The inflammation in alcoholic hepatitis can lead to symptoms such as jaundice (yellowing of the skin and eyes), abdominal pain, nausea, vomiting, loss of appetite, and fever. In severe cases, it can cause liver failure, which may be life-threatening. Treatment typically involves alcohol abstinence, supportive care, and medications to manage symptoms and prevent further liver damage. In some cases, hospitalization and more intensive treatments may be necessary.
Felypressin is a synthetic analogue of vasopressin, which is a natural hormone produced by the pituitary gland in humans and other mammals. The chemical name for Felypressin is O-ethyl-L-tryptophan,8-D-arginine vasopressin. It is used as a vasoconstrictor in some dental and medical procedures to reduce bleeding.
Vasopressin is a potent antidiuretic hormone that helps regulate water balance in the body by increasing water reabsorption in the kidneys. Felypressin, on the other hand, has minimal antidiuretic activity but is a powerful vasoconstrictor, which means it narrows blood vessels and increases blood pressure.
Felypressin is often used in local anesthetic solutions for dental procedures to prolong the duration of anesthesia and reduce bleeding. It is usually administered in combination with other local anesthetics such as lidocaine or prilocaine. The use of Felypressin has been associated with some adverse effects, including nausea, vomiting, and allergic reactions. Therefore, it should be used with caution and only under the supervision of a healthcare professional.
A Peritoneovenous Shunt is a medical device used to treat severe ascites, a condition characterized by the accumulation of excess fluid in the abdominal cavity. The shunt consists of a small tube or catheter that is surgically implanted into the abdominal cavity and connected to another tube that is inserted into a vein, usually in the chest or neck.
The shunt works by allowing the excess fluid in the abdomen to flow through the tube and into the bloodstream, where it can be eliminated from the body through the kidneys. This helps to alleviate the symptoms of ascites, such as abdominal pain and swelling, and can improve the patient's quality of life.
Peritoneovenous shunts are typically used in patients who have not responded to other treatments for ascites, such as diuretics or paracentesis (a procedure in which excess fluid is drained from the abdomen using a needle and syringe). While peritoneovenous shunts can be effective in managing ascites, they do carry some risks, including infection, bleeding, and blockage of the shunt. As with any surgical procedure, it's important for patients to discuss the potential benefits and risks with their healthcare provider before deciding whether a peritoneovenous shunt is right for them.
Albumins are a type of protein found in various biological fluids, including blood plasma. The most well-known albumin is serum albumin, which is produced by the liver and is the most abundant protein in blood plasma. Serum albumin plays several important roles in the body, such as maintaining oncotic pressure (which helps to regulate fluid balance in the body), transporting various substances (such as hormones, fatty acids, and drugs), and acting as an antioxidant.
Albumins are soluble in water and have a molecular weight ranging from 65,000 to 69,000 daltons. They are composed of a single polypeptide chain that contains approximately 585 amino acid residues. The structure of albumin is characterized by a high proportion of alpha-helices and beta-sheets, which give it a stable, folded conformation.
In addition to their role in human physiology, albumins are also used as diagnostic markers in medicine. For example, low serum albumin levels may indicate liver disease, malnutrition, or inflammation, while high levels may be seen in dehydration or certain types of kidney disease. Albumins may also be used as a replacement therapy in patients with severe protein loss, such as those with nephrotic syndrome or burn injuries.
Liver cirrhosis is a chronic, progressive disease characterized by the replacement of normal liver tissue with scarred (fibrotic) tissue, leading to loss of function. The scarring is caused by long-term damage from various sources such as hepatitis, alcohol abuse, nonalcoholic fatty liver disease, and other causes. As the disease advances, it can lead to complications like portal hypertension, fluid accumulation in the abdomen (ascites), impaired brain function (hepatic encephalopathy), and increased risk of liver cancer. It is generally irreversible, but early detection and treatment of underlying causes may help slow down its progression.
A Transjugular Intrahepatic Portosystemic Shunt (TIPS) is a medical procedure that creates an alternative pathway for blood flow from the portal vein to the hepatic vein within the liver. This shunt is composed of a stent, which is a small metal tube that is inserted into the liver using a long needle that is passed through a vein in the neck (jugular vein).
TIPS is typically used to treat complications of portal hypertension, such as variceal bleeding, ascites, and hepatic hydrothorax. By creating a shunt that bypasses the liver, TIPS reduces the pressure in the portal vein, which can help to alleviate these symptoms. However, because the shunt allows blood to bypass the liver, it can also impair liver function and lead to other complications, such as hepatic encephalopathy.
It is important to note that TIPS is a complex procedure that should only be performed by experienced interventional radiologists in a hospital setting with appropriate medical backup and monitoring capabilities.
Liver transplantation is a surgical procedure in which a diseased or failing liver is replaced with a healthy one from a deceased donor or, less commonly, a portion of a liver from a living donor. The goal of the procedure is to restore normal liver function and improve the patient's overall health and quality of life.
Liver transplantation may be recommended for individuals with end-stage liver disease, acute liver failure, certain genetic liver disorders, or liver cancers that cannot be treated effectively with other therapies. The procedure involves complex surgery to remove the diseased liver and implant the new one, followed by a period of recovery and close medical monitoring to ensure proper function and minimize the risk of complications.
The success of liver transplantation has improved significantly in recent years due to advances in surgical techniques, immunosuppressive medications, and post-transplant care. However, it remains a major operation with significant risks and challenges, including the need for lifelong immunosuppression to prevent rejection of the new liver, as well as potential complications such as infection, bleeding, and organ failure.
Liver failure is a serious condition in which the liver is no longer able to perform its normal functions, such as removing toxins and waste products from the blood, producing bile to help digest food, and regulating blood clotting. This can lead to a buildup of toxins in the body, jaundice (yellowing of the skin and eyes), fluid accumulation in the abdomen, and an increased risk of bleeding. Liver failure can be acute (sudden) or chronic (developing over time). Acute liver failure is often caused by medication toxicity, viral hepatitis, or other sudden illnesses. Chronic liver failure is most commonly caused by long-term damage from conditions such as cirrhosis, hepatitis, alcohol abuse, and non-alcoholic fatty liver disease.
It's important to note that Liver Failure is a life threatening condition and need immediate medical attention.
Vasoconstrictor agents are substances that cause the narrowing of blood vessels by constricting the smooth muscle in their walls. This leads to an increase in blood pressure and a decrease in blood flow. They work by activating the sympathetic nervous system, which triggers the release of neurotransmitters such as norepinephrine and epinephrine that bind to alpha-adrenergic receptors on the smooth muscle cells of the blood vessel walls, causing them to contract.
Vasoconstrictor agents are used medically for a variety of purposes, including:
* Treating hypotension (low blood pressure)
* Controlling bleeding during surgery or childbirth
* Relieving symptoms of nasal congestion in conditions such as the common cold or allergies
Examples of vasoconstrictor agents include phenylephrine, oxymetazoline, and epinephrine. It's important to note that prolonged use or excessive doses of vasoconstrictor agents can lead to rebound congestion and other adverse effects, so they should be used with caution and under the guidance of a healthcare professional.
A syndrome, in medical terms, is a set of symptoms that collectively indicate or characterize a disease, disorder, or underlying pathological process. It's essentially a collection of signs and/or symptoms that frequently occur together and can suggest a particular cause or condition, even though the exact physiological mechanisms might not be fully understood.
For example, Down syndrome is characterized by specific physical features, cognitive delays, and other developmental issues resulting from an extra copy of chromosome 21. Similarly, metabolic syndromes like diabetes mellitus type 2 involve a group of risk factors such as obesity, high blood pressure, high blood sugar, and abnormal cholesterol or triglyceride levels that collectively increase the risk of heart disease, stroke, and diabetes.
It's important to note that a syndrome is not a specific diagnosis; rather, it's a pattern of symptoms that can help guide further diagnostic evaluation and management.
Acute kidney injury (AKI), also known as acute renal failure, is a rapid loss of kidney function that occurs over a few hours or days. It is defined as an increase in the serum creatinine level by 0.3 mg/dL within 48 hours or an increase in the creatinine level to more than 1.5 times baseline, which is known or presumed to have occurred within the prior 7 days, or a urine volume of less than 0.5 mL/kg per hour for six hours.
AKI can be caused by a variety of conditions, including decreased blood flow to the kidneys, obstruction of the urinary tract, exposure to toxic substances, and certain medications. Symptoms of AKI may include decreased urine output, fluid retention, electrolyte imbalances, and metabolic acidosis. Treatment typically involves addressing the underlying cause of the injury and providing supportive care, such as dialysis, to help maintain kidney function until the injury resolves.
Portal hypertension is a medical condition characterized by an increased pressure in the portal vein, which is the large blood vessel that carries blood from the intestines, spleen, and pancreas to the liver. Normal portal venous pressure is approximately 5-10 mmHg. Portal hypertension is defined as a portal venous pressure greater than 10 mmHg.
The most common cause of portal hypertension is cirrhosis of the liver, which leads to scarring and narrowing of the small blood vessels in the liver, resulting in increased resistance to blood flow. Other causes include blood clots in the portal vein, inflammation of the liver or bile ducts, and invasive tumors that block the flow of blood through the liver.
Portal hypertension can lead to a number of complications, including the development of abnormal blood vessels (varices) in the esophagus, stomach, and intestines, which are prone to bleeding. Ascites, or the accumulation of fluid in the abdominal cavity, is another common complication of portal hypertension. Other potential complications include encephalopathy, which is a condition characterized by confusion, disorientation, and other neurological symptoms, and an increased risk of bacterial infections.
Treatment of portal hypertension depends on the underlying cause and the severity of the condition. Medications to reduce pressure in the portal vein, such as beta blockers or nitrates, may be used. Endoscopic procedures to band or inject varices can help prevent bleeding. In severe cases, surgery or liver transplantation may be necessary.
Liver diseases refer to a wide range of conditions that affect the normal functioning of the liver. The liver is a vital organ responsible for various critical functions such as detoxification, protein synthesis, and production of biochemicals necessary for digestion.
Liver diseases can be categorized into acute and chronic forms. Acute liver disease comes on rapidly and can be caused by factors like viral infections (hepatitis A, B, C, D, E), drug-induced liver injury, or exposure to toxic substances. Chronic liver disease develops slowly over time, often due to long-term exposure to harmful agents or inherent disorders of the liver.
Common examples of liver diseases include hepatitis, cirrhosis (scarring of the liver tissue), fatty liver disease, alcoholic liver disease, autoimmune liver diseases, genetic/hereditary liver disorders (like Wilson's disease and hemochromatosis), and liver cancers. Symptoms may vary widely depending on the type and stage of the disease but could include jaundice, abdominal pain, fatigue, loss of appetite, nausea, and weight loss.
Early diagnosis and treatment are essential to prevent progression and potential complications associated with liver diseases.
Tyrosinemia is a rare genetic disorder that affects the way the body metabolizes the amino acid tyrosine, which is found in many protein-containing foods. There are three types of tyrosinemia, but type I, also known as hepatorenal tyrosinemia or Hawkins' syndrome, is the most severe and common form.
Tyrosinemia type I is caused by a deficiency of the enzyme fumarylacetoacetase, which is necessary for the breakdown of tyrosine in the body. As a result, toxic intermediates accumulate and can cause damage to the liver, kidneys, and nervous system. Symptoms of tyrosinemia type I may include failure to thrive, vomiting, diarrhea, abdominal pain, jaundice, and mental developmental delays.
If left untreated, tyrosinemia type I can lead to serious complications such as liver cirrhosis, liver cancer, kidney damage, and neurological problems. Treatment typically involves a low-tyrosine diet, medication to reduce tyrosine production, and sometimes liver transplantation. Early diagnosis and treatment are essential for improving outcomes in individuals with tyrosinemia type I.
A kidney, in medical terms, is one of two bean-shaped organs located in the lower back region of the body. They are essential for maintaining homeostasis within the body by performing several crucial functions such as:
1. Regulation of water and electrolyte balance: Kidneys help regulate the amount of water and various electrolytes like sodium, potassium, and calcium in the bloodstream to maintain a stable internal environment.
2. Excretion of waste products: They filter waste products from the blood, including urea (a byproduct of protein metabolism), creatinine (a breakdown product of muscle tissue), and other harmful substances that result from normal cellular functions or external sources like medications and toxins.
3. Endocrine function: Kidneys produce several hormones with important roles in the body, such as erythropoietin (stimulates red blood cell production), renin (regulates blood pressure), and calcitriol (activated form of vitamin D that helps regulate calcium homeostasis).
4. pH balance regulation: Kidneys maintain the proper acid-base balance in the body by excreting either hydrogen ions or bicarbonate ions, depending on whether the blood is too acidic or too alkaline.
5. Blood pressure control: The kidneys play a significant role in regulating blood pressure through the renin-angiotensin-aldosterone system (RAAS), which constricts blood vessels and promotes sodium and water retention to increase blood volume and, consequently, blood pressure.
Anatomically, each kidney is approximately 10-12 cm long, 5-7 cm wide, and 3 cm thick, with a weight of about 120-170 grams. They are surrounded by a protective layer of fat and connected to the urinary system through the renal pelvis, ureters, bladder, and urethra.
An encyclopedia is a comprehensive reference work containing articles on various topics, usually arranged in alphabetical order. In the context of medicine, a medical encyclopedia is a collection of articles that provide information about a wide range of medical topics, including diseases and conditions, treatments, tests, procedures, and anatomy and physiology. Medical encyclopedias may be published in print or electronic formats and are often used as a starting point for researching medical topics. They can provide reliable and accurate information on medical subjects, making them useful resources for healthcare professionals, students, and patients alike. Some well-known examples of medical encyclopedias include the Merck Manual and the Stedman's Medical Dictionary.
Acute liver failure is a sudden and severe loss of liver function that occurs within a few days or weeks. It can be caused by various factors such as drug-induced liver injury, viral hepatitis, or metabolic disorders. In acute liver failure, the liver cannot perform its vital functions, including protein synthesis, detoxification, and metabolism of carbohydrates, fats, and proteins.
The symptoms of acute liver failure include jaundice (yellowing of the skin and eyes), coagulopathy (bleeding disorders), hepatic encephalopathy (neurological symptoms such as confusion, disorientation, and coma), and elevated levels of liver enzymes in the blood. Acute liver failure is a medical emergency that requires immediate hospitalization and treatment, which may include medications, supportive care, and liver transplantation.