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Tackle the complex pathophysiology, diagnosis, and management of hepatorenal syndrome in this Curbsiders classic from #NephMadness 2019 featuring @kidney_boy Joel Topf, HRS expert Juan Carlos Velez (@veleznephhepato), and self-proclaimed most-handsome-nephrologist Bill Whittier (@TWhittier_RUSH) episode! Topics: hepatorenal physiology, renal ultrasound, urine electrolytes, terlipressin, norepinephrine, midodrine and octreotide, albumin challenge, crystalloids vs colloids, and more! Original show notes here.\n
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\nCredits\n\n

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• Written and produced by: Justin Berk MD, Nora Taranto MD
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• Infographic by: Alex M @nephroguy\n
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• Host: Matthew Watto MD
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• Edited by: Matthew Watto MD (audio), Emi Okamoto MD (written materials)
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• Guests: Joel Topf MD, Juan Carlos Velez MD, Bill Whittier MD
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• NephMadness Kidney Pun Contest
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• Disclaimer
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• Intro, guest one-liners
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• Case of acute kidney injury in a patient with cirrhosis
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• Initial differential diagnosis and approach to newly elevated creatinine in cirrhosis (urinalysis, FeNa, urine sodium)
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• History and physical in cirrhosis and AKI
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• Fluid choice
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• Diuretic therapy in cirrhosis and volume overload
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• Is a Renal Ultrasound useful in AKI?
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• Recap: the initial approach to AKI in cirrhosis
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• Therapeutic trials when volume status is uncertain
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• Hepatorenal physiology revisited
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• Vasoconstrictor therapy with octreotide, terlipressin, or norepinephrine
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• Type 1 versus type 2 hepatorenal syndrome
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• Large-volume paracentesis (LVP) in cirrhosis with AKI; how much fluid to remove; use of diuretics or LVP in patients on norepinephrine?!
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• Diagnostic criteria or HRS
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• NephMadness matchups including bile cast nephropathy
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• Outro
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• Grammarly. Visit grammarly.com/curb for 20% off.
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