Which conditions precipitate hepatorenal syndrome (HRS)?

Updated: Oct 16, 2017
  • Author: Deepika Devuni, MD; Chief Editor: BS Anand, MD  more...
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In some patients, HRS may occur spontaneously, whereas in others, it may be associated with infections (particularly spontaneous bacterial peritonitis [SBP]), acute alcoholic hepatitis, or large-volume paracentesis without albumin replacement. SBP precipitates type 1 HRS in approximately 20% of patients despite appropriate and timely diagnosis, treatment, and resolution of infection. Large-volume paracentesis without albumin replacement can precipitate type 1 HRS in up to 15% of patients. Although renal failure occurs in up to 10% of cirrhotics with gastrointestinal bleeding, this is usually in the presence of hypovolemic shock, suggesting that renal failure is related to acute tubular necrosis rather than HRS.

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