{"id":85,"date":"2009-02-28T14:48:25","date_gmt":"2009-02-28T14:48:25","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/gashrs\/"},"modified":"2025-05-14T20:58:00","modified_gmt":"2025-05-14T20:58:00","slug":"gashrs","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/gashrs\/","title":{"rendered":"Diagnostic Criteria of Hepatorenal Syndrome (HRS)"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p><\/p>\n<div class=\"Section1\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Acute kidney injury (AKI) is a common complication in patients with end-stage liver disease and advanced cirrhosis regardless of the underlying cause. Hepatorenal syndrome (HRS), a functional form of kidney failure, is one of the many possible causes of AKI.<\/p>\n<p><!--more--><br \/>\n<strong>Diagnostic Criteria of Hepatorenal Syndrome (HRS)<\/strong><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><strong>Major criteria<\/strong><\/p>\n<ol>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Low glomerular filtration rate, as indicated by serum creatinine greater than 1.5 mg\/dl or 24-hour creatinine clearance lower than 40 ml\/minute<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Absence of shock, ongoing bacterial infection, fluid losses and current treatment with nephrotoxic drugs<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">No sustained improvement in renal function (decrease in serum creatinine to 1.5 mg\/dl or less or increase in creatinine clearance to 40 ml\/minute or more) following diuretic withdrawal and expansion of plasma volume with 1.5 l of a plasma expander<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Proteinuria lower than 500 mg\/day and no ultrasonographic evidence of obstructive uropathy or parenchymal renal disease<\/p>\n<\/li>\n<\/ol>\n<\/div>\n<div class=\"Section1\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><strong>Additional criteria<\/strong><\/p>\n<ol>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Urine volume lower than 500 ml\/day<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Urine sodium lower than 10 mEq\/l<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Urine osmolality greater than plasma osmolality<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Urine red blood cells less than 50 per high-power field<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Serum sodium concentration lower than 130 mEq\/l<\/p>\n<\/li>\n<\/ol>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">All major criteria must be present for the diagnosis of hepatorenal syndrome. Additional criteria are not necessary for the diagnosis, but provide supportive evidence.<\/p>\n<p>&nbsp;<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><strong>Clinical types of hepatorenal syndrome<\/strong><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><strong>\u00a0\u00a0 <\/strong><\/p>\n<ul>\n<li class=\"MsoNormal\"><strong>Type I:<\/strong> Rapid and progressive impairment of renal function as defined by a doubling of the initial serum creatinine to a level higher than 2.5 mg\/dl or a 50% reduction of the initial 24-hour creatinina clearance to a level lower than 20 ml\/minute in less than 2 weeks<\/li>\n<li class=\"MsoNormal\"><strong>Type II:<\/strong> Impairment in renal function (serum creatinine 41.5 mg\/dl) that does not meet the criteria of type I<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p class=\"MsoNormal\"><strong>References:<\/strong><\/p>\n<\/div>\n<ol>\n<li>\n<p class=\"MsoNormal\" align=\"left\">Gines P. Diagnosis and treatment of hepatorenal syndrome. Baillieres Best Pract Res Clin Gastroenterol. 2000 Dec;14(6):945-57. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/11139348\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/p>\n<\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created: Apr 12, 2007<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[53],"tags":[1413,1353],"class_list":["post-85","post","type-post","status-publish","format-standard","hentry","category-gastroenterology","tag-gastroenterology","tag-nephrology"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/85","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=85"}],"version-history":[{"count":4,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/85\/revisions"}],"predecessor-version":[{"id":9076,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/85\/revisions\/9076"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=85"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=85"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=85"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}