Symptoms of hepatorenal syndrome
What is the clinical presentation of hepatorenal syndrome?
Hepatorenal syndrome is a form of kidney injury, so patients present with increased serum creatinine and low urine output.
Clinically, there are two types of hepatorenal syndrome.
1. Acute or type 1 hepatorenal syndrome
This is characterized by a rapidly progressive kidney failure in a cirrhotic patient with ascites.
It usually develops following a precipitating event but can occur spontaneously. Patients are usually very ill, with severe jaundice, coagulopathy, and liver failure. Type 1 hepatorenal syndrome is now renamed as AKI-hepatorenal syndrome.
2. Chronic or type 2 hepatorenal syndrome
This is characterized by moderate kidney failure, with a serum creatinine between 1.5 and 2.5 mg/dL. It evolves slowly over weeks to months in patients with ascites refractory to diuretics.
Patients with type 2 hepatorenal syndrome are usually less ill than those with type 1 hepatorenal syndrome, with a milder degree of jaundice and coagulopathy.