1. bookVolume 59 (2021): Issue 3 (September 2021)
Journal Details
First Published
30 Mar 2015
Publication timeframe
4 times per year
access type Open Access

Hepatorenal syndrome: pathophysiology and evidence-based management update

Published Online: 26 Aug 2021
Page range: 227 - 261
Received: 05 Jan 2021
Journal Details
First Published
30 Mar 2015
Publication timeframe
4 times per year

Hepatorenal syndrome (HRS) is a functional renal failure that develops in patients with advanced hepatic cirrhosis with ascites and in those with fulminant hepatic failure. The prevalence of HRS varies among studies but in general it is the third most common cause of acute kidney injury (AKI) in cirrhotic patients after pre-renal azotemia and acute tubular necrosis. HRS carries a grim prognosis with a mortality rate approaching 90% three months after disease diagnosis. Fortunately, different strategies have been proven to be successful in preventing HRS. Although treatment options are available, they are not universally effective in restoring renal function but they might prolong survival long enough for liver transplantation, which is the ultimate treatment. Much has been learned in the last two decades regarding the pathophysiology and management of this disease which lead to notable evolution in the HRS definition and better understanding on how best to manage HRS patients. In the current review, we will summarize the recent advancement in epidemiology, pathophysiology, and management of HRS.


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