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Definition Return to top
Hepatorenal syndrome is a condition in which the kidneys fail suddenly in a person with cirrhosis of the liver. It is a serious complication of cirrhosis.
Causes Return to top
Hepatorenal syndrome occurs when there is a decrease in kidney function in a person with a liver disorder. Because less urine is removed from the body, nitrogen-containing waste products build up in the bloodstream (azotemia).
The disorder occurs in up to 10% of patients hospitalized with liver failure. It is caused by the built-up effects of liver damage and kidney failure in people with:
Other risk factors include:
Symptoms Return to top
Exams and Tests Return to top
This condition is diagnosed when other causes of kidney failure are ruled out.
A physical examination will not directly reveal kidney failure. However, the exam will usually show signs of chronic liver disease:
Other signs include:
The following may be signs of kidney failure:
The following may be signs of liver failure:
Treatment Return to top
Treatment aims to improve liver function and ensure that there is enough blood in the body and the heart is pumping adequately.
The disorder is generally treated in the same way as kidney failure from any other cause.
Outlook (Prognosis) Return to top
The predicted outcome is poor. Death usually occurs as a result of secondary infections or hemorrhage.
Possible Complications Return to top
When to Contact a Medical Professional Return to top
This disorder most often is diagnosed in the hospital during treatment for a liver disorder.
References Return to top
Cárdenas A, Gines P. Hepatorenal syndrome. Clin Liver Dis. 2006;10:371-385.
Schuppan D, Afdhal NH. Liver cirrhosis. Lancet. 2008;371:838-851.Update Date: 5/20/2008 Updated by: Christian Stone, MD, Division of Gastroenterology, Washington University in St. Louis School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.