Acute renal dysfunction in patients with alcoholic hepatitis

Table 1 International Club of Ascites criteria for the diagnosis of hepatorenal syndrome

1	Presence of cirrhosis and ascites
2	Serum creatinine > 1.5 mg/dL (or 133 mmol/L)
3	No improvement of serum creatinine (decrease equal to or less than 1.5 mg/dL) after at least 48 h of discontinuing diuretics
4	Withdrawal and volume expansion with albumin (recommended dose: 1 g/kg per day up to a maximum of 100 g of albumin/d)
5	Absence of shock
6	No current or recent treatment with nephrotoxic drugs
7	Absence of parenchymal kidney disease as indicated by proteinuria > 500 mg/d, microhematuria (> 50 RBCs/high power field), and/or abnormal renal ultrasound scanning

Table 2 Urinalysis findings in various etiologies of acute kidney injury

AKI type		UA	Urine sodium (mEq/L)	FENA	BUN:Creatinine ratio
Pre-renal		Normal or hyaline casts	< 20	< 1	≥ 20:1
Intrinsic renal
	ATN	Muddy brown casts	> 40	≥ 1
	GN	Dysmorphic RBC and RBC casts	< 20	< 1
	AIN	WBC casts and eosinophils	> 20	≥ 1
Post-renal		Normal or hematuria	>20	Variable	≥ 20:1

ATN: Acute tubular necrosis; GN: Glomerulonephritis; AIN: Acute interstitial nephritis; RBC: Red blood cells; WBC: White blood cells; FENA: Fractional excretion of sodium.