Highlights & Basics
- Hepatorenal syndrome (HRS) is a complication of portal hypertension in the setting of advanced liver disease.
- HRS is diagnosed when kidney function is reduced but evidence of intrinsic kidney disease is absent.
- HRS is classified as HRS-acute kidney injury (HRS-AKI) or HRS-NAKI (i.e., nonAKI). HRS-NAKI is further divided into HRS-acute kidney disease (HRS-AKD; estimated glomerular filtration rate <60 mL/min/1.73 m² for <3 months) and HRS-chronic kidney disease (HRS-CKD; estimated glomerular filtration rate <60 mL/min/1.73 m² for ≥3 months).
- Management of HRS-AKI includes administration of vasoconstrictor drugs plus volume expansion with albumin. However, the definitive treatment of HRS is either liver transplantation or simultaneous liver-kidney transplantation. Renal replacement therapy is considered a temporizing measure while awaiting liver transplantation.
- General prognosis is poor.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Citations
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