inferior vena cava obstruction and may increase the cardiac output and
the renal perfusion.- Dialysis may be indicated in selected patients with HRS. Mainly those
with potentially reversible acute liver disease and those awaiting
orthotopic liver transplantation. - Orthotopic liver transplantation is the definitive line of treatment in
patients with end stage liver disease and HRS. The renal function is
resumed immediately after transplantation.
PROTEINURIA
Proteinuria is a rare presenting complaint of patients. Yet, when
severe enough, it may cause hypoalbuminaemia and oedema. As protein in
urine decreases the surface tension, it causes frothy urine which may be
observed by some patients (bile salts and detergents used in toilets do the
same).
The urine is tested for proteinuria by dip stick test. Dipstick is a
plastic strip, attached to it is a paper impregnated with chemical substance
(tetrabromophenol) which is normally yellow in colour and changes
according to amount of protein in urine (0, +, ++, +++). It can detect a
protein down to a concentration of 300 mg/l. Proteinuria detected by dip
stick test should be confirmed by collecting the 24 hours urine and testing
for quantity of proteinuria using chemical methods.
Definitions:- Proteinuria is a secretion of an abnormal amount of protein in urine.
Normal protein excretion per 24 hours in adults is less than 200 mg.