Hepatorenal syndrome classiication
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aarti Narayan, M.B.B.S [2]
Overview
The hepatorenal syndrome is classified into two categories according to the severity of disease in terms of progression and clinical outcome. Type I hepatorenal syndrome has a rapid progression, whereas type II hepatorenal syndrome progresses gradually to overt renal failure. Both types of the syndrome occur in patients with fulminant hepatic failure or liver failure with cirrhosis and present with increased creatinine levels along with reduced urine output.
Classification
- Type I hepatorenal syndrome
- Rapidly progressive renal failure.
- Serum creatinine levels > 2.5 mg/dl or creatinine clearance < 20 mL/min over a span of less than two weeks.
- Poor prognosis with high mortality (more than 50% after one month)[1].
- Type II hepatorenal syndrome
- Slow in onset and gradual in progression.
- Serum creatinine levels of > 1.5 mg/dl or creatinine clearance < 40 mL/min and a urine sodium of < 10 micro mol/L.
- Poor prognosis and a median survival of six months, unless liver transplantation is performed.
References
- ↑ Arroyo V, Guevara M, Ginès P (2002). "Hepatorenal syndrome in cirrhosis: pathogenesis and treatment". Gastroenterology. 122 (6): 1658–76. PMID 12016430. Unknown parameter
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