Impairment of renal function, which can occur in acute or chronic liver disease. The condition is associated with intrarenal vasoconstriction and extrarenal vasodilation and hypotension, and the kidney disease is functional rather than structural in nature. There are two common clinical presentations. An acute form (type 1) is characterized by rapid spontaneous deterioration in renal function against a background of acute liver failure, acute alcoholic hepatitis, or acute decompensation of chronic cirrhotic liver disease. A chronic form (type 2) is characterized by insidious onset and slowly progressive deterioration in renal function. This is most often observed in patients with decompensated cirrhosis and portal hypertension. The prognosis of hepatorenal syndrome is extremely poor, and the best hope of survival is usually with liver transplantation.
Subjects: Medicine and Health.