[PG notes] What is Hepatorenal Syndrome and Its Diagnosis criteria- Major and Additional

Hepatorenal Syndrome and Its Diagnosis Criteria – Major and Additional

hepatorenal-syndrome-for NEET -pg-Dr Arpit-Devkumar-Helpmedico

  • 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.

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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.


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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



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