Hepatorenal syndrome classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Classification

The hepatorenal syndrome is defined as renal failure that occurs in the setting of liver disease as follows:

Type I HRS

Type I HRS is characterized by rapidly progressive renal failure with a doubling of serum creatinine to a level greater than 221 μmol/L (2.5 mg/dL) or a halving of the creatinine clearance to less than 20 mL/min over a period of less than 2 weeks.

Type II HRS

Type II HRS is characterized by a slowly progressive:

• Increase in serum creatinine level to greater than 133 μmol/L (1.5 mg/dL) or a creatinine clearance of less than 40 mL/min
• Urine sodium < 10 meq/dl