HEPATORENAL SYNDROME: A NARRATIVE LITERATURE REVIEW

Abstract

This article reviewed recent advances in the diagnosis and therapeutic approaches to Hepatorenal Syndrome (HRS), one of the most severe complications of liver failure, characterized by high mortality. The narrative review included studies published in the last five years, available in the PubMed database, focusing on aspects such as pathophysiology, new biomarkers, and therapeutic interventions. Biomarkers like cystatin C have shown promise in early diagnosis, offering a more sensitive alternative to serum creatinine, particularly in patients with advanced cirrhosis. Additionally, the use of terlipressin, combined with albumin, remains one of the main therapeutic strategies to reverse acute HRS. However, liver transplantation remains the only definitive curative treatment, capable of restoring renal function when performed before irreversible damage occurs. The review also highlighted the need for standardization of diagnostic criteria, especially in pediatric populations, and emphasized the importance of early interventions to improve clinical outcomes. Future studies should explore combinations of anti-inflammatory and hemodynamic therapies to optimize the management of HRS and provide better long-term outcomes.