Proposed diagnostic criteria of kidney dysfunction in cirrhosis
Diagnosis | Definition |
Acute kidney injury | Rise in serum creatinine of ≥50% from baseline or a rise of serum creatinine by ≥26.4 μmol/l (≥0.3 mg/dl) in <48 h HRS type 1 is a specific form of acute kidney injury |
Chronic kidney disease | Glomerular filtration rate of <60 ml/min for >3 months calculated using MDRD6 formula HRS type 2 is a specific form of chronic kidney disease |
Acute-on-chronic kidney disease | Rise in serum creatinine of ≥50% from baseline or a rise of serum creatinine by ≥26.4 μmol/l (≥0.3 mg/dl) in <48 h in a patient with cirrhosis whose glomerular filtration rate is <60 ml/min for >3 months calculated using MDRD6 formula |
Both the acute deterioration in renal function and the background chronic renal dysfunction can be functional or structural in nature.
HRS, hepatorenal syndrome; MDRD6, Modification of Diet in Renal Disease formula calculated using six variables of serum creatinine, age, gender, albumin, blood urea nitrogen and whether or not the patient is African-American.