Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Feb 28, 2017; 9(6): 293-299
Published online Feb 28, 2017. doi: 10.4254/wjh.v9.i6.293
Hepatorenal syndrome: Update on diagnosis and therapy
Juan G Acevedo, Matthew E Cramp
Juan G Acevedo, Matthew E Cramp, South West Liver Unit, Plymouth Hospitals Trust, Plymouth, Devon PL6 8DH, United Kingdom
Matthew E Cramp, Hepatology Research Group, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth PL6 8BT, United Kingdom
Author contributions: Acevedo JG wrote the manuscript; Cramp ME critically reviewed the manuscript.
Conflict-of-interest statement: Acevedo JG and Cramp ME declare no conflict of interest related to this publication.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Juan G Acevedo, MD, PhD, South West Liver Unit, Plymouth Hospitals Trust, Derriford Road, Plymouth, Devon PL6 8DH, United Kingdom. jacevedo@nhs.net
Telephone: +44-17-52432723 Fax: +44-17-52517576
Received: September 29, 2016
Peer-review started: October 2, 2016
First decision: October 20, 2016
Revised: December 30, 2016
Accepted: February 8, 2017
Article in press: February 13, 2017
Published online: February 28, 2017
Core Tip

Core tip: Hepatorenal syndrome (HRS) is a life-threatening complication present in very advanced liver cirrhosis. This manuscript addresses many recent advances in this field, including the recent change in the definition of HRS according to acute kidney injury criteria, the potential consequences of the adoption of this new definition, and the use of biomarkers to help in the diagnostic algorithm. Moreover, it reviews the recent advances in treatment of HRS such as the use of continuous infusion of terlipressin instead of bolus and the low efficacy of midodrine plus octreotide. Potential areas of research are identified as well.