Attending rounds: How many "organ"-renal syndromes are recognized?

There are 3 "organ"-renal syndromes:

- Hepatorenal Syndrome (HRS) - development of renal failure in patients with advanced chronic liver disease, occasionally fulminant hepatitis, who have portal hypertension and ascites; 40% of patients with cirrhosis and ascites will develop HRS.

- Cardiorenal Syndrome - presentation of combined cardiac and renal dysfunction.

- Pulmonary-Renal Syndrome (PRS) - presentation of combined alveolar hemorrhage and glomerulonephritis.

Pulmonary-Renal Syndrome is the least well-recognized among the 3 syndromes. For example, it is not even listed under this name in the current edition of the "universal textbook of medicine" UpToDate (version 15.3). There is an old proverb: beware the man of a single book (homo unius libri).

Pulmonary-renal syndrome (PRS) is diffuse alveolar hemorrhage and glomerulonephritis occurring simultaneously. It sound like Goodpasture's syndrome which is logical since Goodpasture's is the prototype cause of PRS. Pulmonary-renal syndrome can can also be caused by SLE, Wegener's granulomatosis, microscopic polyangiitis, and other connective tissue diseases -- see the Merck Manual for a full list of causes of PRS.


Acute decompensated heart failure: The cardiorenal syndrome. CCJM (PDF).
The Clinical Challenge of Cardiorenal Syndrome. Circulation, 2004.
Are You Dependent on UpToDate for Your Clinical Practice?
Cirrhosis - JAMA Patient Page, 2012.
Image source: Wikipedia, GNU Free Documentation License.

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