{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T18:38:13Z","timestamp":1783535893347,"version":"3.55.0"},"reference-count":93,"publisher":"Georg Thieme Verlag KG","issue":"03","funder":[{"DOI":"10.13039\/501100001809","name":"The National Nature Science Foundation of China","doi-asserted-by":"crossref","award":["82200673"],"award-info":[{"award-number":["82200673"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Liver Dis"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:p>Acute kidney injury (AKI) is a critical and often fatal complication in decompensated cirrhosis, significantly affecting inpatient survival rates. Hepatorenal syndrome (HRS), a distinct subtype of AKI, develops in individuals with advanced cirrhosis and portal hypertension. It is marked by progressive kidney dysfunction, poor prognosis, and frequently causes death before liver transplantation. The pathogenesis of HRS involves vasodilation of the splanchnic vessels, leading to overactivation of the endogenous vasoactive systems, circulatory dysfunction, and reduced renal perfusion, which ultimately impairs glomerular filtration. Recent studies have highlighted the role of systemic inflammation in exacerbating renal damage. Despite these changes, renal histology in HRS usually shows no significant abnormalities, and there is typically no hematuria, proteinuria, or abnormal findings on ultrasound. Common risk factors for HRS include spontaneous bacterial peritonitis, infections, and large-volume paracentesis without albumin infusion. Diagnosing HRS is challenging, particularly in distinguishing it from acute tubular necrosis, due to the absence of specific biomarkers. Treatment primarily involves vasoconstrictors such as terlipressin and albumin, with liver transplantation being the definitive therapeutic option. This review provides an updated understanding of HRS, addressing its pathophysiology, diagnosis, management, and future challenges, based on recent expert consensus.<\/jats:p>","DOI":"10.1055\/a-2570-3330","type":"journal-article","created":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T19:27:06Z","timestamp":1743535626000},"page":"328-347","source":"Crossref","is-referenced-by-count":4,"title":["Understanding and Treating Hepatorenal Syndrome: Insights from Recent Research"],"prefix":"10.1055","volume":"45","author":[{"given":"Yuli","family":"Song","sequence":"additional","affiliation":[{"name":"State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaochen","family":"Yang","sequence":"additional","affiliation":[{"name":"State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengbo","family":"Yu","sequence":"additional","affiliation":[{"name":"State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,4,29]]},"reference":[{"issue":"01","key":"ref1","first-page":"1","article-title":"Hepatorenal syndrome","volume":"4","author":"P Gin\u00e8s","year":"2018","journal-title":"Nat Rev Dis Primers"},{"issue":"10","key":"ref2","doi-asserted-by":"crossref","first-page":"1486","DOI":"10.1111\/apt.17232","article-title":"Healthcare burden and outcomes of hepatorenal syndrome among cirrhosis-related hospitalisations in the US","volume":"56","author":"A K Singal","year":"2022","journal-title":"Aliment Pharmacol Ther"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1002\/hep.31884","article-title":"Diagnosis, evaluation, and management of ascites, spontaneous bacterial peritonitis and hepatorenal syndrome: 2021 Practice Guidance by the American Association for the Study of Liver Diseases","volume":"74","author":"S W 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