Hepatorenal syndrome HRS

• Facts:
  Dangerous compications of end stage liver disease, occurring in up to 10% of patients with cirrhosis
  
  Decreased GFR in the absence of shock, proteinuria, or another cause of renal dysfunction, and a failure to respond to 1.5L normal saline blous
  
  Type 1 HRS
  Rapidly progressive
  Most patients die within 10wks, without treatment
  
  Type 2 HRS
  Progresses more slowly
  Average survival of 3-6 months
• Treatment:
  Liver transplantation
  Midodrine and octreotide
• Associated With:
  Cirrhosis
  Prerenal ARF (renal hypoperfusion)