Single article

DOI: 10.47026/2413-4864-2020-3-7-19

Karzakova L.M., Ivanova A.L., Kudryashov S.I., Sokolova E.V., Lutkova T.S.

Immune Mechanisms for the Development of Hepatorenal Syndrome in Liver Cirrhosis

Keywords: hepato-renal syndrome, cirrhosis of the liver, innate immunity, cytokines

Hepatorenal syndrome is a life-threatening complication of liver cirrhosis. 90% of patients with liver cirrhosis die within 2 months since the onset of hepatorenal syndrome development. For many years the hypothesis of the hemodynamic mechanism of hepatorenal syndrome development was accepted as the only true one, according to this hypothesis compensatory systemic vasodilation in response to portal hypertension causes renal ischemia and the development of functional specific acute kidney damage, the so-called “hepatorenal syndrome – acute kidney damage”. In recent years some works were published that substantiate the role of a systemic inflammatory reaction in the development of hepatorenal syndrome; this inflammatory reaction being associated with activation of innate immunity cells in response to a bacterial infection, including that to the microflora of the intestine which is adjacent to the liver. Data has been obtained which indicated that Toll-like receptors (TLRs), in particular TLR4 and TLR9 are involved in the development of hepatorenal syndrome.


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About authors

Karzakova Luiza M.
Doctor of Medical Sciences, Professor, Head of Internal Diseases Department, Chuvash State University, Russia, Cheboksary (
Ivanova Antonina L.
Post-Graduate Student of Internal Diseases Department, Chuvash State University, Russia, Cheboksary (
Kudryashov Sergei I.
Candidate of Medical Sciences, Assistant Lecturer of Internal Diseases Department, Chuvash State University, Russia, Cheboksary (
Sokolova Evgeniya V.
Candidate of Medical Sciences, Associate Professor of the Department of Immunology, Russian National Research Medical University named after N.I. Pirogov, Russia, Moscow (
Lutkova Tatyana S.
Candidate of Medical Sciences, Associate Professor of Internal Diseases Department, Chuvash State University, Russia, Cheboksary (

Article link

Karzakova L.M., Ivanova A.L., Kudryashov S.I., Sokolova E.V., Lutkova T.S. Immune Mechanisms for the Development of Hepatorenal Syndrome in Liver Cirrhosis [Electronic resource] // Acta medica Eurasica. – 2020. – №3. P. 7-19. – URL: DOI: 10.47026/2413-4864-2020-3-7-19.