Abstract
Hepatorenal syndrome represents an end stage of circulation control in liver disease, when a relative hypotension and extreme regulatory mechanisms practically stop the urine production in otherwise organically intact kidneys. The very cause of this is the complex impact of portal hypertension in combination with various extent of hepatocellular insufficiency on systemic ciruclation.
It is a condition of very bad prognosis, and only the last years have offered some kinds of effective treatment as TIPS or combination of albumin with terlipressin. However, the definitive treatment in most cases remains liver transplantation, which is, regrettably, usually to late to perform.
On the other hand, it is necessary to differentiate functional renal failure of other causes (intensive diuretic treatment, GI bleeding, SBP or sepsis), which responds well to causal therapy and transplantation is better applicable in such a case.