ATN: acute tubular necrosis; KDIGO: Kidney Disease: Improving Global Outcomes. * Acute kidney injury is defined in this context as an increase in serum creatinine ≥0.3 mg/dL within 48 hours or ≥50% within 7 days; this is consistent with KDIGO criteria. ¶ Refer to UpToDate content on the evaluation of patients with acute kidney injury. Δ Evidence for a alternative etiology of acute kidney injury makes hepatorenal syndrome less likely (hepatorenal syndrome is generally a diagnosis of exclusion). However, such patients may also have superimposed hepatorenal syndrome as a second disorder. ◊ Unexpected clinical course indicates that management of presumed etiology did not result in the expected outcome (eg, worsening kidney function despite relief of diagnosed urinary tract obstruction, failure of contrast-associated injury to resolve in the anticipated timeline, etc). § This disorder is referred to as hepatorenal syndrome with acute kidney injury (HRS-AKI) by some experts; other experts refer to this entity as type 1 hepatorenal syndrome.
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