Cirrhosis is one of the leading causes of mortality from non-communicable diseases, with complications arising as liver function deteriorates. HRS and HPS represent the most severe outcomes of cirrhosis, associated with systemic vasodilation driven by elevated levels of vasodilators like nitric oxide (NO). These complications significantly impair renal and pulmonary functions, leading to high mortality rates.
TIPS, by shunting blood from the portal to systemic circulation, can potentially improve renal function by increasing systemic blood volume. However, the diversion of NO through TIPS could exacerbate systemic hypotension, posing a risk to renal function. TIPS procedure The TIPS procedure involves the creation of a shunt between the portal vein and a hepatic vein, effectively reducing portal hypertension.
This minimally invasive procedure has shown efficacy in treating complications of cirrhosis such as variceal bleeding and refractory ascites. However, it carries risks, including hepatic encephalopathy, particularly in patients with pre-existing conditions that could worsen post-procedure outcomes. Effects of TIPS on renal function TIPS generally improves renal function in patients with portal hypertension, regardless of HRS presence.
Studies have demonstrated that TIPS can increase glomerular filtration rates (GFR) and reduce serum creatinine levels, particularly in patients with refractory ascites. However, the data is insufficient to recommend TIPS specifically for HR.
