Hepatorenal Syndrome Diagnosis - Medical Algorithm

Are you evaluating a patient with cirrhosis and ascites?

Yes

Serum creatinine

Does the patient's renal function improve with volume expansion?

Yes

Is renal ultrasound normal?

Yes

24 hour urine protein

mg per day

24 hour urine volume

mL per day

Urine osmolality

mOsm per kg H2O

Plasma osmolality

mOsm per kg H2O

Urine RBC count per high power field (HPF)

Urine sodium

mEq/L

Serum sodium

mEq/L

Is/Has the patient?

• in shock?

Yes

• had exposure to a nephrotoxin?

Yes

• had increased fluid loss?

Yes

• had an ongoing infection?

Yes

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Data complete?

Evaluation appropriate?

Number of major criteria present

Number of minor criteria present

Does the patient have the hepatorenal syndrome?

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Interpretation and Description

References

Next Steps in Evaluation

Selection
- Cirrhosis and Ascites | Risk Factors for Hepatorenal Syndrome

Evaluation

Results

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Interpretation and Description

References

Next Steps in Evaluation

Diagnosis

Therapy

Specialty

Objective

ICD-10

The Criteria of the International Ascites Club for the Hepatorenal Syndrome

Purpose: To determine if a patient with cirrhosis has the hepatorenal syndrome using the criteria of the International Ascites Club.

Evaluation

Results

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Interpretation and Description

References

Next Steps in Evaluation

Diagnosis

Therapy

Specialty

Objective

ICD-10