Hepatorenal Syndrome

Definition:

• Functional renal failure in patients with portal hypertension / end-stage liver disease

Pathophysiology:

• Splanchnic vasodilation
• Mesenteric angiogenesis
• Decreased effective blood volume which results in decreased renal perfusion
  

Diagnosis supported by:

• Oliguria: <1mL/kg/day
• Urine sodium <10mEq/L
• FeNa <1%
• Ratio of Urine : Plasma Cr  <10
• Normal urinary sediment
• Absence of hypovolemia
• Exclusion of other kidney pathology

Treatment:

• Timely liver transplant
• Complete renal recovery is expected