The treatment of Hepatorenal Syndrome Treatment Market includes the Liver transplantation as the definitive treatment for HRS, but it is not always possible owing to the short survival expectancy. Nevertheless, liver transplantation should still be done in suitable patients even after the improvement of renal function because the outcome of HRS is poor. Therapies introduced during the past few years, such as vasoconstrictor drugs (vasopressin analogs, α-adrenergic agonists) or the transjugular intrahepatic portosystemic shunt (TIPS), are effective in improving renal function.
Vasoconstrictor therapy is the primary medical treatment for type 1 HRS. Terlipressin is the vasoconstrictor drug of choice in Europe. The product is not approved in the US and currently, it is being investigated in phase III trial to prove its safety and efficacy.
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Transjugular Intrahepatic Portosystemic Shunt (TIPS) involves the insertion of an intrahepatic stent that connects the portal vein to the hepatic vein. This shunts portal blood into the systemic circulation, which reduces the portal pressure and increases the systemic venous return. Furthermore, TIPS can aggravate liver failure and precipitate encephalopathy.
Renal replacement therapy (RRT) may be used to treat specific complications of renal impairment such as metabolic acidosis, hyperkalemia, volume overload, and uraemic symptoms. It may have a role in patients who are unresponsive to vasoconstrictor drugs and where TIPS is contraindicated. Along with this, Prometheus is an extracorporeal technique involving fractional plasma separation and adsorption with hemodialysis for removing water-soluble and albumin-bound substances. However, given the lack of definitive survival benefit and high costs, the studies suggest that extracorporeal support systems should be limited to research protocols.
Several treatment options exist, but, at present, only liver transplantation offers genuine hope for cure and longevity. Challenges for the study of HRS include establishing when renal dysfunction in patients with cirrhosis occurs, largely related to the limitations include the uncertain value of renal biomarkers, and the limited availability of pharmacologic and other therapies to address the fundamental underlying pathophysiology.
Although to fulfill the unmet need, much has been learned about the pathophysiology, clinical behavior, and natural history of HRS. Standardized diagnostic criteria have been developed and implemented worldwide, allowing for a more uniform diagnosis and consistent reporting of the disease. One of the most important developments in HRS is the move away from a diagnosis based on a single level of serum Cr to a diagnosis based on dynamic serial changes in serum Cr level such as the recently revised recommendations of the International Ascites Club (IAC) for hepatorenal disorders in cirrhosis. This change has been stimulated by a perceived need to establish more precisely an early diagnosis of the disease.
Therefore, future directions should include the development of an accurate diagnostic test for HRS. This is important as earlier diagnosis and thus treatment is likely to improve survival.
Source:- Hepatorenal Syndrome Market Research
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