Issues of the diagnosis of hepatorenal syndrome in the practice of clinical medicine and pathoanatomy

Abstract

Objective: to study the results of autopsies of patients with liver cirrhosis, to analyze the frequency of diagnosing «hepatorenal syndrome» (HRS) and its conformity with diagnostic criteria. Material and methods. A retrospective cohort analysis of 130 autopsies of patients with liver cirrhosis was performed. HRS was detected clinically and/or pathologically in 43.8 % of the patients. Clinical data and autopsy protocols of 27 patients with liver cirrhosis were analyzed in detail for compliance of the diagnosis of HRS with diagnostic criteria. The data were recorded and analyzed in MS Excel 2010. Results. The frequency of the diagnosis «hepatorenal syndrome» significantly exceeds the real prevalence of this pathology; its diagnostic criteria are often not followed; HRS is not considered to be the diagnosis of exclusion; the type of HRS is not indicated; for healthcare specialists there is often equality in the terms «hepatorenal syndrome» and «hepato-renal failure». Conclusion. To improve the quality of medical care for patients with liver cirrhosis, it is necessary to adhere more strictly to the clinical protocol «Diagnosis and treatment of patients with diseases of the digestive system», to introduce more accurate additions to it, and to increase knowledge of healthcare specialists in the field of HRS diagnosis.