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.
- 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.
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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