Hepatorenal Syndrome
Serious liver disease from any cause may be complicated by a form of renal’ failure termed the hepatorenal syndrome. It almost invariably occurs in the presence of severe ascites. Typically, the kidneys are histologically normal, with the capacity of regaining normal function in the event of a recovery of liver function. The renal dysfunction is characterized by oliguria, low urine sodium (<10 mEq/L), and azotemia.
The hepatorenal syndrome is usually progressive and fatal. It should only be diagnosed after plasma volume depletion (a common cause of reversible, prerenal azotemia in patients with cirrhosis, particularly with diuretic use) and other forms of acute renal injury have been ruled out.
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