Hepatorenal Syndrome (HRS) - Diagnostic Criteria
HRS-AKI (Acute: previously known as HRS Type 1)
 • ↑ Creatinine by 0.3 mg/dL (27 μmol/L) in 48h or by 50% in 3 months
 • Cirrhosis + ascites
 • No response to 1 g/kg/d of HAS x 48h (60kg patient: 3x 100ml 20% HAS)
 • No shock
 • No nephrotoxics (e.g. diuretics, NSAIDs)
 • No structural kidney injury: No proteinuria (>500mg/d), No haematuria, Normal renal ultrasound
HRS-NAKI (Non-Acute: previously known as HRS Type 2)
 • HRS-AKD
     - ↑ Creatinine by 50% in 3 months
     - eGFR < 60ml/min/1.73m2
     - No other cause of kidney disease
     - Cirrhosis + ascites
 • HRS-CKD
     - eGFR < 60ml/min/1.73m2
     - No other cause of kidney disease
     - Cirrhosis + ascites

Dr. Keith Siau @drkeithsiau

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