Table 1.

Diagnostic criteria of HRSa

Major Criteriab
    Low GFR, as indicated by serum creatinine >1.5 mg/dl or 24-h creatinine clearance <40 ml/min
    Absence of shock, ongoing bacterial infection, fluid losses, and current treatment with nephrotoxic drugs
    No sustained improvement in renal function (decrease in serum creatinine to ≤1.5 mg/dl or increase in creatinine clearance to ≥40 ml/min) after diuretic withdrawal and expansion of plasma volume with 1.5 L of a plasma expander
    Proteinuria <500 mg/d and no ultrasonographic evidence of obstructive uropathy or parenchymal renal disease
Additional Criteria
    Urine volume <500 ml/d
    Urine sodium <10 mEq/L
    Urine osmolality greater than plasma osmolality
    Urine red blood cells <50/high-power field
    Serum sodium concentration <130 mEq/L
  • a HRS, hepatorenal syndrome.

  • b Only major criteria are necessary for diagnosis of HRS.