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Year : 2020  |  Volume : 7  |  Issue : 2  |  Page : 83-89

Hepatorenal syndrome: A review into changing definition, diagnostic criteria, pathophysiology, and management

Department of Gastroenterology, IGMC, Shimla, Himachal Pradesh, India

Correspondence Address:
Vishal Bodh
Department of Gastroenterology, IGMC, Shimla, Himachal Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/cjhr.cjhr_117_19

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Hepatorenal syndrome (HRS) is a form of kidney function impairment that characteristically occurs in patients with cirrhosis. The diagnostic criteria for this syndrome have been revised throughout the years, with recent revisions aimed at improving earlier diagnosis and treatment. HRS definition has been updated recently by the International Club of Ascites in accordance with Kidney Disease Improving Global Outcomes acute kidney injury (AKI) classification. Recent changes in terminology have led to acute or Type I HRS being referred to as AKI-HRS and chronic or Type II HRS as chronic kidney disease (CKD)-HRS. The contribution of systemic inflammation, a key feature of cirrhosis, in the development of HRS has been highlighted in recent years. The current standard of care for the management of HRS involves the use of vasoconstrictor therapy and volume expansion with albumin. All patients do not respond to treatment, and even in those who respond, early mortality rates are very high in the absence of liver transplantation (LT). LT is the only curative treatment of HRS.

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