Table 2.

Temporal considerations in pathophysiology of CRS-5.

Attribute	CRS5 Acute (Sepsis) (Fig. 1)	CRS5 Chronic (Cirrhosis) (Fig. 2)
Time for organ dysfunction	Short: hours to days	Long: weeks to months
Underlying organ function	May be superimposed on underlying cardiac and kidney disease	Heart and kidney have adaptive responses that fail over time
Sequence of organ involvement	Generally simultaneous or in close proximity to each other	One organ precedes the other e.g. cardiac dysfunction precedes renal in cirrhosis
Underlying disease	Systemic event contributes to CRS5	Precipitating events can transition to an acute deterioration in CRS5 e.g. GI bleed can precipitate hepatorenal syndrome
Pathophysiology	Direct effects on organs	Failure of adaptive responses over time
Mechanisms	Determined by underlying disease	Determined by adaptive changes
Reversibility	Possible with control of sepsis and organ support	Limited unless there is replacement of diseased organ e.g. liver transplant