Renal dysfunction in patients with cirrhosis: Where do we stand?

Table 1 International Ascites Club definition and diagnostic criteria for hepatorenal syndrome[7,116]

1996 criteria
Major criteria
Chronic or acute liver disease with advanced hepatic failure and portal hypertension
Serum creatinine > 1.5 mg/dL or 24-h creatinine clearance of < 40 mL/min
Absence of shock, ongoing bacterial infection, and current or recent treatment with nephrotoxic drugs. Absence of gastrointestinal fluid losses (repeated vomiting or intense diarrhea) or renal fluid losses
No sustained improvement in renal function defined as a decrease in serum creatinine to < 1.5 mg/dL or increase in creatinine clearance to 40 mL/min or more following diuretic withdrawal and expansion of plasma volume with 1.5 L of isotonic saline
Proteinuria < 500 mg/dL and no ultrasonographic evidence of obstructive uropathy or parenchymal renal disease
Minor criteria
Urine volume < 500 mL/d	Urine osmolality > plasma osmolality
Urine sodium < 10 mEq/L	Urine red blood cells < 50 per high power field