Table 2.

Criteria for diagnosis of hepatorenal syndrome

Cirrhosis with ascites
Serum creatinine>1.5 mg/dl
Absence of shock
Absence of hypovolemia defined as no sustained improvement of renal function (creatinine decreasing to <1.5 mg/dl) after at least 2 days of diuretic withdrawal (if on diuretics) and volume expansion with albumin at 1 g/kg per day up to a maximum of 100 g/d
No current or recent treatment with nephrotoxic drugs
Absence of parenchymal renal disease as defined by proteinuria<0.5 g/d, no microhematuria (<50 red cells/high-powered field), and normal renal ultrasonography
  • Type 1 hepatorenal syndrome (HRS) is characterized by a rapid and progressive impairment in renal function (increase in serum creatinine of equal to or greater than 100% compared with baseline to a level higher than 2.5 mg/dl in less than 2 weeks). Type 2 HRS is characterized by a stable or less progressive impairment in renal function. Modified from references 8 and 10, with permission.