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., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
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].