HRS-AKI

• Diagnosis of cirrhosis and ascites

• Diagnosis of AKI according to AKI-ICA

• No response after 2 consecutive days of diuretic withdrawal and plasma expansion with albumin 1g per kg body weight

• Absence of shock

• No current or recent use of nephrotoxic drugs (NSAIDs, aminoglycosides, non-ionic contrast etc)

• No macroscopic signs of structural kidney injury defined as*

► Absence of proteinuria (>500mg/day)

► Absence of microhematuria (>50 RBCs per high power field)

► Normal finding on renal ultrasonography

*Patients who fulfill these criteria may still have structural damage such as tubular damage. Urine biomarkers will become an important tool in differentiating between HRS and acute tubular necrosis