Hepatorenal Syndrome and Its Diagnosis Criteria – Major and Additional

• Hepatorenal Syndrome is defined as a state of functional renal failure (Reduced GFR) in patients with severe liver disease.
• Structurally/Histologically the kidneys are normal and recover function after successful liver transplantation.[MCQ]
• Pathogenetic hallmark of hepatorenal syndrome is intense renal vasoconstriction with systemic vasodilation.
• The diagnosis of hepatorenal syndrome is based according to following diagnostic criteria.

Also Read:

• Subjectwise Book for NEET PG : Complete List 
• NEET- PG 2018 Notification and Subjectwise marks Breakup

Diagnosis criteria of Hepatorenal Syndrome

For diagnosis of hepatorenal syndrome there are some: Major points [all points must be fulfilled to make diagnosis of Hepatorenal syndrome]

There are some additional points also which supports the diagnosis of Hepatorenal syndrome which all are not neccessary to be present.

Download These:

• Hutchinson’s Manual of Clinical Medicine [pdf]
• Harrison’s 19th edition [pdf]

MAJOR CRITERIA : for Hepatorenal Syndrome Diagnosis

• Low Glomerular filteration rate, as indicated by serum creatinine >1.5mg/dl or 24 hr creatinine clearance <40ml/min
• Absence of shock, ongoing bacterial infection, fluid losses, and current treatment with nephrotoxic drugs.
• No sustaned improvement in renal function (measured bydecrease in serum creatitnine to 1.5 on increase in creatinine clearance to 40 ml/min) after diuretic withdrawal and expansion of plasma volume witg 1.5 ltr. of plasma expander.
• Proteinuria <500mg/dl and no ultrasonographic evidence of obstructive uropathy or parenchymal renal disease.

Additional Criteria :for Hepatorenal syndrome Diagnosis

• Urine volume <500ml/dl
• Urine sodium <10meq/ltr
• Urine osmolality greater than plasma osmolality
• Urine RBCs <50/high powere field
• Sr. Sodium concentration <130 mEqL

This is all you need to know about hepatorenal syndrome and its diagnosis criteria for NEET- PG and your clinics.

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