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Do you mean hepatorenal syndrome? Thank you.
I'm sorry for the delay. I didn't know you had replied.
I am an OBGYN doctor.
What are your symptoms?
Why do you think sodium is building up in your blood? Thank you.
Do you have chronic liver disease that you know of?
Do you take any medications?
Do you have heart problems?
Hepatorenal syndrome occurs in people with chronic bad liver disease who then develop kidney failure.
Basic blood tests can detect if you have any kidney failure or liver problems.
I don't think you could have hepatorenal syndrome with a normal liver scan and normal blood tests.
Lots of things cause swelling and fluid retention. And many people have cold hands and feet.
I don't think you need to wait for a kidney specialist. I would recommend that you see an internal medicine doctor or a family doctor.
Emergency rooms are often not very helpful except for emergencies.
Low blood pressure is usually better than high blood pressure, and is not usually a sign of disease.
With either type 1 or 2, you need to have chronic liver disease first. Then the types 1 or 2 relate to how quickly the kidneys fail.
As I mentioned, despite your history of heavy drinking, a liver scan and liver blood tests would detect whether you had chronic liver disease.
Blood pressure drop while standing is called orthostatic hypotension. It's fairly common and doesn't usually indicate serious disease.
There are many causes of orthostatic hypotension. Hepatorenal syndrome is way far down on the list.
I can certainly see why you are concerned about liver problems and your general health.
I would recommend an internal medicine referral, but as long as you have a referral to a kidney doctor, he/she should be able to figure out what's going on.
Acute liver failure can occur, but it doesn't sound like you have that.
Kidney failure is pretty black and white. Blood tests will show a high creatinine and low creatinine clearance.
Liver failure can be a little harder to know, but both the scan and blood tests will usually show evidence.
GFR is usually usually calculated using blood creatinine. A GFR is somewhat low, but would need to be repeated and also have urine evaluated for protein and blood to know if there is kidney damage.
The amount and concentration of sodium in the blood is regulated through the kidneys, so healthy kidneys are necessary to have a normal amount of sodium in the blood.
I'm still pretty sure that you don't have hepatorenal syndrome. I would wait and see what the doctor finds.
You have done the most important thing, which is to stop alcohol.
There are not very good treatments for hepatorenal syndrome other than liver transplantation.