Published online Nov 6, 2015. doi: 10.5527/wjn.v4.i5.511
Peer-review started: April 15, 2015
First decision: May 13, 2015
Revised: August 13, 2015
Accepted: September 16, 2015
Article in press: September 18, 2015
Published online: November 6, 2015
Acute kidney injury (AKI) is a common complication in patients with end-stage liver disease and advanced cirrhosis regardless of the underlying cause. Hepatorenal syndrome (HRS), a functional form of kidney failure, is one of the many possible causes of AKI. HRS is potentially reversible but involves highly complex pathogenetic mechanisms and equally complex clinical and therapeutic management. Once HRS has developed, it has a very poor prognosis. This review focuses on the diagnostic approach to HRS and discusses the therapeutic protocols currently adopted in clinical practice.
Core tip: Hepatorenal syndrome is a functional and potentially reversible form of kidney failure. The pathophysiological bases of this disease are complex and not fully understood. The aim of this review is to focus the current diagnostic approach and the updated therapeutic protocols adopted in clinical practice.