What are the risk factors associated with the development of hepatorenal syndrome (HRS) in patients with cirrhosis who are nonazotemic?

Updated: Oct 16, 2017
  • Author: Deepika Devuni, MD; Chief Editor: BS Anand, MD  more...
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Answer

The following is a list of risk factors associated with the development of HRS in patients with cirrhosis who are nonazotemic. All measurements were obtained after a minimum of 5 days on a low-salt diet and without diuretics.

  • Low urinary sodium excretion (<5 mEq/L)

  • Low serum sodium (dilutional hyponatremia)

  • Reduced free-water excretion after water load

  • Low mean arterial pressure

  • High plasma renin activity

  • Increased plasma norepinephrine

  • Low plasma osmolality

  • High urine osmolality

  • High serum potassium

  • Previous episodes of ascites

  • Absence of hepatomegaly

  • Presence of esophageal varices

  • Poor nutritional status

  • Moderately increased serum urea (>30 mg/dL)

  • Moderately increased serum creatinine (>1.5 mg/dL)

  • Moderately reduced GFR (<50 mL/min)


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