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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