Hepatorenal syndrome (HRS) is the development of renal failure in patients with advanced chronic liver disease. It
can be precipitated by infection (SBP) and large volume paracentesis without albumin replacement. It carries a very
poor prognosis.

It is characterized by:

  • Reduced urinary output (< 500 ml in 24 hours in adults)
  • Abnormal renal function test (progressively raising creatinine)
  • Normal urine sediment


  • Correct hypovolemia
  • Treat precipitating factors
  • Refer for specialised management