Hepatorenal Syndrome

Hepatorenal syndrome is a form of acute kidney injury that occurs in chronic liver diseaseand acute fulminant liver failure. This syndrome features a rapid progressive decline in renalfunction in the absence of other obvious causes of renal dysfunction. The pathophysiologyof this syndrome is still not completely understood, and several mechanisms have beenproposed to explain its pathogenesis. The characteristic feature of hepatorenal syndrome isintense renal vasoconstriction. The local production of vasodilator substances as a result ofportal hypertension have a central role in the pathogenesis of the hepatorenal syndrome asthey lead to splanchnic pooling and decreased effective systemic arterial plasma volume andrenal vasoconstriction. Hepatorenal syndrome is a diagnosis of exclusion and is considered achallenging medical condition in both diagnosis and treatment as it is associated with a poorprognosis. This article will review the two main hypotheses about the pathogenesis, diagnosticcriteria, and treatment approaches to the hepatorenal syndrome.