Hepatorenal Syndrome - A Severe Liver Complication

By Dr. P. Kar in Gastroenterology, Hepatology & Endoscopy

Mar 05 , 2018 | 2 min read

Hepatorenal Syndrome or HRS is a health complication that occurs due to end-stage renal disease. This is a progressive condition where the patient suffers from rapid deterioration in the kidney that later leads to kidney failure. It mostly affects the people who have chronic liver diseases such as liver cirrhosis. This condition can be fatal if not treated well on time.

Hepatorenal syndrome is categorized into two types: Type 1 HRS and Type 2 HRS.

Type 1 HRS: This type of HRS has a rapid progression of kidney failure and an overproduction of creatinine. Common symptoms include low blood pressure, oedema, decreased urination and azotemia.
Type 2 HRS: This type of HRS has a slow progression as compared to Type 1 HRS. Ascites is a major symptom in Type 2 HRS. Dr. P. Kar, Director & HOD - Gastroenterology & Hepatology, Max Super Speciality Hospital, Vaishali mentions the symptoms below of this syndrome. 


Below are the common symptoms that a person who has HRS may experience:

  • Delirium
  • Confusion
  • Vomiting and nausea
  • Dementia
  • Weight gain
  • Jaundice
  • Swollen abdomen
  • Decreased urination
  • Dark-colored urine

Once the symptoms are identified, the patient must get immediate medical care.

Causes and Risk Factors

Hepatorenal syndrome mostly happens in individuals who are already dealing with cirrhosis. However, there are various risk factors that increase the chances of HRS which are as follows:

  • Unstable blood pressure
  • Acute alcoholic hepatitis
  • Bleeding in gastrointestinal tract
  • Use of diuretics
  • Spontaneous bacterial peritonitis
  • Infections in areas like kidney

Also, Check Liver Cirrhosis Causes & Risks


The first step of the diagnosis process begins with the physical examination and the identification of the symptoms associated with this syndrome. The doctors will also conduct various blood and urine tests to evaluate the functions of liver and kidney.

In cases where HRS is not caused by cirrhosis, the doctors will recommend other tests to check for viral or alcoholic hepatitis.


As per the reports of the diagnosis, doctors may recommend any of the below-listed treatment options:


Doctors may recommend various medications that can help in controlling low blood pressure caused by HRS. In some cases, dialysis is also performed to improve the kidney symptoms by filtering harmful waste from the blood, medications serve only as a bridge towards liver transplantations.

Liver Transplantation

Remain the treatment of choice for hepatorenal syndrome. A liver transplant treats the liver disease as well as impaired renal function. The patient must get their names listed in the waiting list for a liver transplant in India under Max Healthcare.

Patients looking for a liver transplant hospital in Delhi can seek medical guidance from a renowned liver transplant specialist. We at Max Healthcare, offer dedicated services to our patients to help them attain a healthy and disease-free life.


Prevention is mostly associated with a healthy lifestyle that can keep the liver in a good state. To avoid hepatorenal syndrome, one must reduce their risk factors that may lead to cirrhosis.

It is also important to prevent hepatitis virus. While hepatitis A and B can be prevented through vaccination, avoiding hepatitis C can be done through various measures. Some of the common preventive measures are washing your hands after a handshake, avoiding shared needles and illegal drugs. An individual should also get their sexual partner tested for hepatitis C as it can spread through sexual activities as well.