Hepato-Renal Syndrome: A Complication of Advanced Chronic Liver Disease with Portal Hypertension

Abstract

The pathophysiology of circulatory and renal dysfunction in cirrhosis and the treatment of ascites and related conditions (hepatorenal syndrome and spontaneous bacterial peritonitis) have been research topics of major interest during the last two decades. Hepatorenal Syndrome (HRS) is a potentially reversible “functional” renal failure occurring in (a) Cirrhosis of liver with ascites (portal hypertension) and hepatic failure, (b) Acute Liver Failure and (c) Alcoholic hepatitis. However, functional renal dysfunction is present even in early stages of chronic liver diseases of any etiology, and HRS is the extreme manifestation of the same. HRS is usually seen in advanced stages presenting with azotemia and ultimately renal failure. Anatomically and histologically the kidneys are normal.