TABLE 1

Diagnostic criteria for hepatorenal syndrome with acute kidney injury

Cirrhosis; acute liver failure; ACLF
Increase in serum creatinine:

  • ≥ 0.3 mg/dL within 48 hours or

  • ≥ 50% from baseline according to ICA criteria and/or

  • Urinary output ≤ 0.5 mL/kg ≥ 6 hours.

No full or partial response after at least 2 days of diuretic withdrawal and volume expansion with albumin (1 g/kg body weight per day to a maximum 100 g/day)
Absence of shock
No current or recent treatment with nephrotoxic drugs
Absence of parenchymal disease as indicated by proteinuria > 500 mg/day, microhematuria and/or abnormal renal ultrasonography

  • ACLF = acute-on-chronic liver failure

  • Reprinted from J Hepatol 2019; 71(4):811–822. doi:10.1016/j.ep.2019.07.002. Angeli P, Garcia-Tsao G, Nadim MK, Parikh CR.

  • News in pathophysiology, definition and classification of hepatorenal syndrome: a step beyond the International Club of Ascites (ICA) consensus document, with permission from Elsevier.