Diagnostic testing: HRS is diagnosed when other causes of kidney failure are clinically ruled out.
Laboratory studies may include:
• BUN and serum creatinine levels;
• Urinalysis showing increased urine specific gravity; and
• Tests for low serum sodium and very low urine sodium concentration.
Liver tests will show increased prothrombin time, low serum albumin, and sometimes
increased serum ammonia levels.
Imaging studies may include abdominal ultrasound. Signs of hepatic encephalopathy
may also be present.
Physical findings: Symptoms of HRS may include:
• Orthostatic hypotension (a fall in blood pressure occurring when a person sits up
or stands up suddenly);
• Change in mental status;
• Muscle spasms/jerks;
• Dark-colored urine;
• Decreased urine production (oliguria);
• Unexplained weight gain; and
• Yellow skin (jaundice).
The clinical examination will also show signs of chronic liver failure.