This is listed as the cause of death on my fathers death certificate along with liver failure, renal failure and liver cancer associated with hepititis C. In general 鈥淩efractory Hypotension鈥?means 鈥淪tubborn Abnormally Low Blood Pressure鈥? This is caused by widening of the blood vessels due to various health problems.
For example, Hepatitis C causes Acute Liver Failure (ALF), while AFL causes the widening of blood vessels, hence creating abnormal low blood pressure. I extracted only one paragraph from an article that discusses the impact of ALF on Refractive Hypotension. I have only inserted the meaning of several medical terminologies for easy reading in the parenthesis. If you are interested, check the website for detailed info.
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Acute liver failure
http://pmj.bmjjournals.com/cgi/content/f...
Cardiovascular and respiratory
A hyperdynamic circulation with peripheral vasodilatation (Widening of blood vessels) and central volume depletion leading to hypotension are characteristic of Acute Liver Failure (ALF). Hypotension (abnormally Low Blood Pressure) may respond to volume repletion but many patients will require vasopressor therapy directed by invasive haemodynamic monitoring. It has recently been recognised that adrenal dysfunction can contribute to refractory hypotension (Stubborn abnormally low blood pressure) and a trial of hydrocortisone is warranted in these patients.
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Similarly, Renal Failure is Acute Kidney Failure. Acute renal failure is sudden loss of the ability of the kidneys to excrete wastes, concentrate urine, and conserve electrolytes. The kidneys鈥?job is to filter wastes and excrete fluid by using the bloodstream's own natural pressure. There are numerous potential causes of damage to the kidneys, including Decreased blood flow -- this may occur when there is extremely low blood pressure (Refractory Hypotension).
I am not the doctor, but it appears that if ALF causes Refractory Hypotension, then Refractory Hypotension can cause Renal Failure.
Other symptoms of Renal Failure according to 鈥淢edline Plus鈥?website (http://www.nlm.nih.gov/medlineplus/ency/... is as follow:
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鈥ecreased blood flow -- this may occur when there is extremely low blood pressure caused by trauma, complicated surgery, septic shock, hemorrhage, or burns; associated dehydration; or other severe or complicated illnesses.
鈥cute tubular necrosis (ATN) -- may occur when tissues aren't getting enough oxygen or when the renal artery is blocked or narrowed (see acute arterial occlusion of the kidney and renal artery stenosis).
鈥ver-exposure to metals, solvents, radiographic contrast materials, certain antibiotics, and other medications or substances.
鈥yoglobinuria (myoglobin in the urine) -- this condition may be caused by rhabdomyolysis, alcohol abuse, a crush injury, tissue death of muscles from any cause, seizures, and other disorders.
鈥irect injury to the kidney.
鈥nfections such as acute pyelonephritis or septicemia.
鈥rinary tract obstruction, such as a narrowing of the urinary tract (stricture), tumors, kidney stones, nephrocalcinosis or enlarged prostate with subsequent acute bilateral obstructive uropathy.
鈥evere acute nephritic syndrome.
鈥isorders of the blood, such as idiopathic thrombocytopenic purpura (ITP), transfusion reaction, or other hemolytic disorders, malignant hypertension and disorders resulting from childbirth, such as bleeding placenta abruptio or placenta previa can damage the kidneys.
鈥utoimmune disorders such as scleroderma can cause acute renal failure.
鈥n young children, hemolytic uremic syndrome is an increasingly common cause of acute renal failure. A toxin-secreting bacterium, Escherichia coli, found in contaminated undercooked meats, has been implicated as the cause of hemolytic uremic syndrome.
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Liver Cancer, also known as 鈥淗epatocellular carcinoma鈥? involves a malignant tumor of the liver.
According to 鈥淢edline Plus鈥?website (http://www.nlm.nih.gov/medlineplus/ency/...
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Hepatocellular carcinoma accounts for 80% to 90% of all liver cancers. It occurs more often in men than women and occurs mostly in people 50 to 60 years old. The disease is more common in parts of Africa and Asia than in North or South America and Europe.
The cause of liver cancer is usually cirrhosis, or scarring of the liver. Cirrhosis may be caused by viral hepatitis, primarily hepatitis B and C, alcohol abuse, hemochromatosis, certain autoimmune diseases of the liver, and a whole host of other diseases that result in chronic inflammation of the liver leading to scarring. The most common cause for cirrhosis in the U.S. is alcohol abuse.
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Thus the information gathered, it can be concluded that Hepatitis C had caused ALF, which in turn ALF has lead to Liver Cancer and refractory hypotension. Which in turn, refractory hypotension, which is widening of blood vessels, has caused the Renal Failure. The order may vary, if he had other health issues or a few were developed at the same time.
If you want to know more about those diseases, check the provided URLs. refractory means it didn't respond to whatever the doctors tried
hypotension means that the blood pressure is low
"refractory hypotension" means that your father had low blood pressure that kept getting lower no matter what the doctors did. I'm sure they tried giving intravenous fluids but in liver failure the fluid tends to wind up in the legs and in the abdomen (did he have a big distended tummy?) because of low albumen (a blood protein that keeps fluid in the blood stream and helps stop it from leaking out). refractory means resistant to treatment
hypotension means low blood pressure
hence
low blood pressure resistant to treatment |
