Management of hepatorenal syndrome

Table 1 Criteria for diagnosis of hepatorenal syndrome in cirrhosis

Cirrhosis with ascites

Serum creatinine > 1.5 mg/dL (133 μmol/L)

Absence of shock

Absence of hypovolemia as defined by no sustained improvement of renal function (creatinine decreasing to < 133 μmol/L) following at least 2 d of diuretic withdrawal (if on diuretics) and volume expansion with albumin at 1 g/kg per day up to a maximum of 100 g/d

No current or recent treatment with nephrotoxic drugs

Absence of parenchymal renal disease as defined by proteinuria < 0.5 g/d, no microhematuria (< 50 red cells/high powered field) and normal renal ultrasonography