Purpose of the presentation:

1. To provide an overview of the pathogenesis of cerebral edema in patients with acute liver and renal failure, with special emphasis on the multifactorial nature of this condition.
2. To provide an overview of the management of cerebral edema from a nephrologist’s perspective with a brief description of a novel approach for delivering osmotherapy.

Overview of the presentation:

The following topics will be covered chronologically:

1. Epidemiology of acute liver failure.
2. Clinical presentation of acute liver failure with emphasis on concomitant renal failure, hemodynamic instability, hyponatremia, and systemic inflammation.
3. Pathogenesis of cerebral edema: role of the failed liver in generating cerebral edema; potential roles of the failed kidney, dialysis, hyponatremia, and systemic inflammation in worsening cerebral edema.
4. Management of cerebral edema from a nephrologist’s perspective: effect of slow dialysis on intra-cranial pressures; description of dialysis-based osmotherapy and advantages over conventional delivery of osmotherapy

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