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What is Hepatorenal Syndrome & How is it Treated?|Types, Causes, Symptoms, Life Expectancy, Prognosis of Hepatorenal Syndrome

What is Hepatorenal Syndrome?

Hepatorenal syndrome (HRS) is a medical condition where the patient suffers from progressive kidney failure. Hepatorenal syndrome commonly occurs in patients with severe liver damage, which usually occurs as a result of cirrhosis. As the function of the kidneys stop, there is accumulation of toxins in the body which gradually leads to liver failure.

What is Hepatorenal Syndrome?

What are the Causes & Risk Factors of Hepatorenal Syndrome?

Hepatorenal Syndrome almost always occurs as a complication of liver disease, and more commonly this liver disease is cirrhosis. Factors which increase the risk of patients suffering from cirrhosis to experience Hepatorenal Syndrome are:

  • Using diuretics.
  • Unstable blood pressure.
  • Acute alcoholic hepatitis.
  • Spontaneous bacterial peritonitis.
  • Gastrointestinal bleeding.
  • Other infections, particularly kidney infections.

What are the Types of Hepatorenal Syndrome?

There are two types of Hepatorenal Syndrome:

Type-1 Hepatorenal Syndrome: In this type of Hepatorenal Syndrome the patient has rapid kidney failure with overproduction of creatinine.

Type-2 Hepatorenal Syndrome: In this type of Hepatorenal Syndrome, there is gradual damage to the patient’s kidneys which progresses more slowly when compared to

Type-1 HRS. The symptoms of type-2 Hepatorenal Syndrome are also more subtle.

What is the Life Expectancy of Patients with Hepatorenal Syndrome?

Hepatorenal Syndrome is a very serious and fatal medical condition. Patients suffering from type-1 Hepatorenal Syndrome usually will have an average survival time of about two weeks. Most of the patients suffering from type-1 Hepatorenal Syndrome will not survive beyond eight to 10 weeks. The chances of survival are there only if the patient undergoes an emergent liver transplantation. The average life expectancy for patients with type-2 Hepatorenal Syndrome is about six months.

What Are the Symptoms of Hepatorenal Syndrome?

Some of the common symptoms of Hepatorenal Syndrome are listed below. Patient when experiencing them should contact medical care ASAP; especially if the patient is also undergoing treatment for other kidney issues.

Common symptoms of Hepatorenal Syndrome consist of: Confusion, nausea, delirium, vomiting, jaundice, weight gain, dementia, dark-colored urine, decreased output of urine and abdominal swelling.

How is Hepatorenal Syndrome Diagnosed?

Physical examination of the patient is conducted where the signs of Hepatorenal Syndrome can be detected which include: skin sores, swelling of the breast tissue, accumulation of fluid in the abdomen and jaundice.

The doctor also will exclude other causes of kidney failure by doing a series of blood and urine tests to assess the function of the liver and kidney. Rarely, hepatorenal syndrome can also occur in patients having liver damage due to causes other than cirrhosis, such as alcoholic or viral hepatitis.

How is Hepatorenal Syndrome Treated?

Vasoconstrictors are the medications used for treating Hepatorenal Syndrome, which manage the low blood pressure occurring in hepatorenal syndrome. Patient may need to undergo dialysis to improve the kidney symptoms. The most effective treatment for Hepatorenal Syndrome is liver transplantation which greatly improves the prognosis and survival rate of the patient.

What are the Complications of Hepatorenal Syndrome?

Complications of Hepatorenal Syndrome are seen when the patient develops end-stage kidney disease and they consist of fluid accumulation, organ damage, secondary infections and coma.

Can Hepatorenal Syndrome be Prevented?

The only surest way for preventing Hepatorenal Syndrome is keeping the liver healthy. This can be done by quitting alcohol consumption or keeping it to minimal.

Hepatorenal Syndrome can also be prevented by preventing Hepatitis A and B by vaccination. However, hepatitis C does not have any vaccine currently.

What is the Prognosis of Hepatorenal Syndrome?

Hepatorenal Syndrome is a life threatening condition with a poor prognosis; however, the prognosis improves if the patient gets a liver transplantation.


  1. Mayo Clinic. (2021). Hepatorenal Syndrome. https://www.mayoclinic.org/diseases-conditions/hepatorenal-syndrome/symptoms-causes/syc-20352506
  2. National Institute of Diabetes and Digestive and Kidney Diseases. (2021). Kidney Disease Statistics for the United States. https://www.niddk.nih.gov/health-information/health-statistics/kidney-disease

Also Read:

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:September 27, 2023

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