Acute renal injury after partial hepatectomy

Table 3 Diagnostic criteria of hepatorenal syndrome type of acute kidney injury in patients with cirrhosis[68]

HRS-AKI

Diagnosis of cirrhosis and ascites

Diagnosis of AKI according to ICA-AKI criteria (Table 2)

No response after 2 consecutive days of diuretic withdrawal and plasma volume expansion with albumin 1 g/kg bodyweight

Absence of shock

No current or recent use of nephrotoxic drugs (NSAIDs, aminoglycosides, iodinated contrast media, etc.)

No macroscopic signs of structural kidney injury, defined as

Absence of proteinuria (> 500 mg/d)

Absence of microhaematuria (> 50 RBCs per high power field)

Normal findings on renal ultrasonography

Patients who fulfil these criteria may still have structural damage such as tubular damage. Urine biomarkers will become an important element in making a more accurate differential diagnosis between HRS and acute tubular necrosis

HRS: Hepatorenal syndrome; AKI: Acute kidney injury; ICA: International club of ascites; NSAIDs: Non-steroidal anti-inflammatory drugs; RBCs: Red blood cells.