ACUTE KIDNEY INJURY (AKI)-HEPATORENAL SYNDROME

SUMMARY

Criteria to establish a diagnosis of hepatorenal syndrome:
1. Cirrhosis with ascites and evidence of portal hypertension (ascites, splenomegaly, oesophageal varices, leukopenia, thrombocytopenia, anaemia)
2. A serum creatinine > 1.5mg/dL that progresses over days to weeks

3. Lack of improvement in renal function after withdrawal of diuretics and volume expansion with albumin (1 g/kg of body weight per day up to 100 g/day) for at least 2 days

4. No evidence of parenchymal kidney disease (normal U/A, proteinuria < 500 mg/d, normal renal ultrasound)

5. Absence of any other apparent cause of AKI, including shock, nephrotoxins, and infection (except peritonitis)

Reference(s)

Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].