Ascites in hepatorenal syndrome

Q:  Resistant ascites is a feature of (select one) 

A) Type 1 hepatorenal syndrome 

B) Type 2 hepatorenal syndrome

Answer: B

Hepatorenal syndrome is divided into two types depending on the severity of the decline

• Type 1 is more life-threatening and is characterized by a rapid decline of renal function. It is defined by at least a twofold increase in serum creatinine within 2 weeks. Although patients are non-oliguric in the early phase of the disease oliguria becomes universal later in the course.
• Type 2 is less severe and the major feature is the resistant ascites unresponsive to diuretics.

#nephrology

#hepatology

References:

1. Ginès P, Schrier RW. Renal failure in cirrhosis. N Engl J Med 2009; 361:1279.

2. Arroyo V, Ginès P, Gerbes AL, et al. Definition and diagnostic criteria of refractory ascites and hepatorenal syndrome in cirrhosis. International Ascites Club. Hepatology 1996; 23:164. 

3. Salerno F, Gerbes A, Ginès P, et al. Diagnosis, prevention and treatment of hepatorenal syndrome in cirrhosis. Gut 2007; 56:1310.