Pediatric Hepatorenal Syndrome

Pediatric cases involving hepatorenal syndrome is a severe-complication of end-stage liver disease. This can actually be classified into two types:

1. Type 1 hepatorenal syndrome – Acute liver failure is the recognized cause of this type. The renal function suddenly drops causing for the build up of createnine and BUN levels. The glomerular filtration rate is lessened as the kidney losses its functions to strain particles in the blood. The inability of the kidneys to excrete may also pursue the excessive loss of sodium, more fluid escapes the body in effort to bring out the large molecules of toxins.

2. Type 2 hepatorenal syndrome – Hepatic dysfunction is the source of this type. The deterioration of the renal function is gradual and the management of this case involves solving problems over and over again. The ascites that brought about by this type could not be solved through diuretics.

Pediatric Hepatorenal Syndrome is called a syndrome since the original cause of this illness has not be cleared or known at this time. Sets of signs and symptoms are gathered as it is observed. The major cause of this syndrome has been pointed out to the decreased renal blood flow as well as arteriolar vasoconstriction.

Signs and Symptoms:

  1. Ascites – The decreased renal function accumulates the fluid on other surface such as the peritoneal part. This is the sign that the patient is on its severe part.
  2. Jaundice – The type 1 hepatorenal syndrome includes this sign in the early stage.
  3. Hypotension – The systemic pressure is decreased due to the dilation of the veins as a compensation to the constriction of the arteries in the kidneys.

A procedure prescribed for patients is renal biopsy wherein the findings will target the cause of the renal failure. Patients with this state must be under medications that would control the blood pressure. Vasocontrictors are the drug of choice as allows the vessels once dilated to constrict in order to prevent hypotension.

Hemodialysis is also done depending on the physician’s observation and the capacity of the kidneys. Although this can be traumatic for a child to undergo, it must be done. Surgical interventions are also geared in decreasing the effects of ascites such as difficulty in breathing.

A team of health officers must work hand in hand. For example, these people may be nephrologists, gastroeneterologist and surgeons. Although the prognosis on these two types of hepatorenal syndromes, compliance to the prescribed medications and treatment may matter in the long run.

Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

What Do You Think?