Hepatorenal syndrome (HRS) is a kidney impairment in decompensated liver disease characterized by decreased renal perfusion caused by severe splanchnic vasodilatation in the absence ...
Cirrhosis with ascites
Serum creatinine >1.5 mg/dL (>133 mmol/L)
Absence of hypovolemia—defined by no sustained improvement of renal function (creatinine decreasing to...
Avoid nephrotoxins and contrast agents.
Relieve urinary obstruction (if present).
Terlipressin (not available in the U...
Singh V, Ghosh S, Singh B, et al. Noradrenaline vs. terlipressin in the treatment of hepatorenal syndrome: a randomized study. J Hepatol. 2012;56(6):1293–1298.
Tyagi P, Sharma ...
Cirrhosis of the Liver; Hepatitis A; Hepatitis B; Hepatitis C
Algorithms: Acetaminophen Poisoning, Treatment; Acute Kidney Injury (Acute Renal Failure)
HRS is a diagnosis of exclusion.
Decompensated cirrhosis with ascites and hyponatremia are common in patients with HRS.
Medical therapy is typically ineffective in HRS.
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