What is characteristic of Hepatorenal syndrome: Hypernatremia, Hypertension, Asterixis, Significant proteinuria, or Low urinary sodium?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Article Review Status
Submitted
Under Review
Approved

Last updated: February 17, 2025 • View editorial policy

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:

  • Low urinary sodium 5 Other options such as Hypernatremia, Hypertension, Asterixis, and Significant proteinuria are not directly mentioned as characteristic of Hepatorenal syndrome in the provided study 5

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.