Hepatorenal syndrome (HRS)

HRS is defined as an acute, functional and progressive reduction in renal blood flow and glomerular filtration rate (GFR) secondary to intense renal cortical vasoconstriction in the setting of decompensated liver disease. Other aetiologies for renal failure in liver disease must be excluded. HRS can be classified as type 1, with a rapidly progressive decline in GFR (<2 weeks), or type 2, which is not as rapidly progressive (>2 weeks). Although not diagnostic, a low spot urinary sodium (<5 mmol/L) is in keeping with a diagnosis of hepatorenal syndrome (HRS), assuming that the patient does not have intravascular volume depletion.