Treatment:

Treatment aims to improve liver function and ensure that there is enough blood in the body and the heart is pumping adequately.

The disorder is generally treated in the same way as kidney failure from any other cause.

• All unnecessary medicines are stopped, especially the antibiotic neomycin, ibuprofen and other NSAIDs, and diuretics ("water pills").
• Dialysis may improve symptoms.
• Medications such as octreotide, albumin, and dopamine may be used temporarily to improve kidney function.
• Surgery to place a shunt (called a Levine shunt) from the abdominal space (peritoneum) to the jugular vein may relieve some of the symptoms of kidney failure. However, surgical shunts are rarely placed, because severe liver disease makes surgery very risky. A nonsurgical shunt (known as TIPS) may be tried in some patients.

Expectations (prognosis):

The predicted outcome is poor. Death usually occurs as a result of secondary infections or hemorrhage.

Complications:

• Bleeding
• Damage to, and failure of, many organ systems
• End-stage kidney disease
• Fluid overload with congestive heart failure or pulmonary edema
• Hepatic coma
• Secondary infections

Calling your health care provider:

This disorder most often is diagnosed in the hospital during treatment for a liver disorder.