Exam Cram

• Hepatorenal Syndrome (HRS)

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Outline

Background

Assessment

History

Examination

Investigations

Scores

Diagnosis

Diagnostic criteria: 

• Cirrhosis with ascites

• Cr  > 133

• Absence of hypovolaemia

• No current/ recent nephrotoxic drugs

• Absence of parenchymal disease

Differentials:

Classification

HRS 1

• Presentation: doubling of Cr > 221 within two weeks. 

• Management: terlipressin

HRS 2

• Presentation: gradual increase in creatinine

• Management: Na+ restriction & spironolactone

Management

Resources and References

Written in 2025