From the Guidelines
The characteristic of hepatorenal syndrome is low urinary sodium (<10 mmol/l), which is a key diagnostic criterion 1. This condition is often associated with advanced liver disease and is marked by significant renal dysfunction. In contrast, hypernatremia, hypertension, asterixis, and significant proteinuria with urinary casts are not specific characteristics of hepatorenal syndrome, although asterixis may be present in patients with underlying liver disease 2.
Key Diagnostic Features
- Low urinary sodium (<10 mmol/l) is a critical diagnostic feature, and its presence helps to distinguish hepatorenal syndrome from other causes of renal dysfunction 1.
- The absence of shock, ongoing bacterial infection, recent treatment with nephrotoxic drugs, or massive gastrointestinal or renal fluid losses are also important criteria 3.
- Serum creatinine greater than 1.5 mg/dL or 24-hour creatinine clearance less than 40 mL per minute are additional key features 3.
Differential Diagnosis
- Asterixis can be observed in other diseases, such as uremia, and is not pathognomonic of hepatorenal syndrome 2.
- Significant proteinuria (>500 mg/d) and ultrasonographic evidence of obstructive uropathy or parenchymal kidney disease are not characteristic of hepatorenal syndrome 3.
- Hypernatremia and hypertension are not specific characteristics of hepatorenal syndrome, although they may be present in patients with underlying liver disease 1, 4.
From the Research
Characteristics of Hepatorenal Syndrome
The following are characteristics of Hepatorenal syndrome: