#191 Hepatorenal Syndrome Part 2 on Management: 5 Pearls Segment

Core IM | Internal Medicine Podcast

Core IM Team

Mental Health, Education, Health & Fitness, Medicine

4.8 • 1K Ratings

🗓️ 22 October 2025

⏱️ 36 minutes

🔗️ Recording | iTunes | RSS

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Summary

What really works when treating HRS? Vasoconstrictors like terlipressin vs. norepinephrine vs. midodrine: how do we decide which to use? Do you give albumin? When do you give Lasix or another diuretic? When is the better choice transplant, dialysis, or even palliative care?

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🔹 Transcript & Show Notes

Timestamps:

(00:12) | Introduction and Overview of Hepatorenal Treatment

(03:38) | Vasoconstrictors Focus: Terlipressin, Norepinephrine, and Midodrine

(12:32) | Finding the Right Dose of Albumin and Knowing When to Stop

(15:06) | Volume Management: Balancing MAP, Diuretics, and Creatinine

(21:42) | Understanding the High Mortality of HRS-AKI

(32:30) | Transplant, Dialysis, or Palliation Care

Tags: CoreIM, Internal Medicine, Primary Care, Medical Education, IMCore, Physician Assistant, Nurse Practitioner, Medical Student, Hepatorenal Syndrome, HRS-AKI, Cirrhosis, Nephrology, Liver Disease

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Transcript

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0:00.0	Let's be honest, between the back-to-back patients, inbox overload, and real life, our schedules
0:05.7	can be a bit of a mess. And that's why we're a fan of Oakstone CME's programs, including their
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0:17.3	work. You get audio, video, text-based formats, all easy access through either a mobile
0:22.7	app or the desktop. You can throw on a mix-up episode while walking to work or prepping for dinner.
0:28.0	And it's just really satisfying to check off a topic while multitasking. The platform is pretty
0:32.4	intuitive, streamlined, no fuss. Whether you've got 10 minutes or an hour, you can jump in,
0:37.4	make progress, and move on with your day. Honestly, it's become one of my favorite ways to keep learning without carving out quote-unquote study time. So if you've got a commute time, gym time, or just some downtime, you've got some CME time. Use the code core 25 for 25% off. That's exclusive to core am listeners go to oakstone.com back
0:56.7	slash mixap that's oakstone forward slash mixap mksap and don't forget to use the code core 25
1:04.7	welcome to the coram five pearls podcast bringing you high yield evidence based pearls i'm dr sharia
1:10.5	trevetty and I'm joined by
1:11.9	I am Dr. Noah Markowitz, a PGI-3 internal medicine resident at Montefiure in the Bronx.
1:17.7	Today's episode is part two of our two-part series all about hepatorenal syndrome.
1:22.9	And if you haven't done already, go back and listen to the last episode on All Things
1:27.3	Diagnosis.
1:28.9	Today's episode will be All Things Treatment.
1:32.0	And let's remind ourselves who our wonderful discussants are.
1:35.7	Hi, I'm Marina Serper.
1:37.2	I am a hepatologist at the University of Pennsylvania.
1:41.4	Hi, I am Juan Caro Feliz.
1:43.5	I am a nephrologist at Oxyner Health in New Orleans.
1:48.7	My name is Nick Mazumder.
	...

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