Almanac of Clinical MedicineAlmanac of Clinical MedicineАльманах клинической медицины2072-05052587-9294Moscow Regional Research and Clinical Institute (MONIKI)14810.18786/2072-0505-2014-33-23-31TOPICAL ARTICLESПРОБЛЕМНЫЕ СТАТЬИHEPATORENAL SYNDROME: DIAGNOSTIC AND THERAPEUTIC MANAGEMENTГЕПАТОРЕНАЛЬНЫЙ СИНДРОМ: ПРАКТИЧЕСКИЕ РЕКОМЕНДАЦИИ ПО ДИАГНОСТИКЕ И ЛЕЧЕНИЮBakulinI. G.БакулинИ. Г.
Russian Federation

д-р мед. наук, профессор, зав. отделом гепатологии ГБУЗ МКНЦ ДЗМ, зав. кафедрой гастроэнтерологии МИУВ ФГБОУ ВПО «МГУПП»

igbakulin@yandex.ruVarlamichevaA. A.ВарламичеваА. А.
Russian Federation

мл. науч. сотр. отдела гепатологии ГБУЗ МКНЦ ДЗМ

Moscow Clinical Scientific Center, Moscow Health Care DepartmentГБУЗ «Московский клинический научно-практический центр Департамента здравоохранения г. Москвы» (ГБУЗ МКНЦ ДЗМ)86 Shosse Entuziastov, Moscow, 111123, Russian Federation Medical Institute of Postgraduate Education, Moscow State University of Food Production111123, г. Москва, шоссе Энтузиастов, 86, Российская Федерация Медицинский институт усовершенствования врачей ФГБОУ ВПО «Московский государственный университет пищевых производств» (МИУВ ФГБОУ ВПО «МГУПП»)11 Volokolamskoe sh., Moscow, 125080, Russian Federation125080, г. Москва, Волоколамское ш., 11, Российская Федерация86 Shosse Entuziastov, Moscow, 111123, Russian Federation111123, г. Москва, шоссе Энтузиастов, 86, Российская Федерация150620143323311402201614022016Copyright ©; 2014, Bakulin I.G., Varlamicheva A.A.Copyright ©; 2014, Бакулин И.Г., Варламичева А.А.2014Bakulin I.G., Varlamicheva A.A.Бакулин И.Г., Варламичева А.А.https://creativecommons.org/licenses/by/4.0https://almclinmed.ru/jour/article/view/148

The practical guidelines on diagnosis and management of hepatorenal syndrome, which could be useful for general medical practitioners, gastroenterologists, and hepatologists, are considered in this paper. Selected recommendations are based on integrated clinical data, international recommendations and results of clinical trials. Beginning from theoretical grounds of hepatorenal syndrome (its definition, diagnostic criteria, and classification), acute kidney injury, and spontaneous bacterial peritonitis, the paper contains diagnostic algorithms (in particular, in ascites, for early revealing hepatorenal syndrome), and main approaches to therapy and prevention. The efficacy criteria and monitoring rules for the terlipressin-based therapy are listed.

Настоящее практическое руководство для врачей общей практики, гастроэнтерологов и гепатологов содержит специально отобранные объединенные данные, основанные на международных рекомендациях с учетом результатов крупных клинических исследований. Описаны теоретические положения, касающиеся гепаторенального синдрома (определение, критерии диагностики, классификация), острого повреждения почек и спонтанного бактериального перитонита. Приведен алгоритм диагностики при асците для раннего выявления гепаторенального синдрома, представлены основные лечебно-профилактические мероприятия. С позиции доказательной медицины обсуждены принципы терапии с акцентом на критериях эффективности, в том числе прогностических в зависимости от исходных клинико-лабораторных показателей, и правилах мониторинга.

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