HRS-AKI Criteria (Hepatorenal Syndrome, 2024)
Applies the 2024 ADQI/ICA criteria for hepatorenal syndrome with acute kidney injury.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Cirrhosis with ascites
- Yes
- AKI by creatinine or urine output
- Yes
- No improvement after volume
- Yes
- No alternative primary cause
- Yes
Result: HRS-AKI criteria met - all four present.
The tool opens with these values already filled in. Replace them with your own.
What the result means
- All four required
- Cirrhosis with ascites; AKI by creatinine or urine output; no improvement within 24 h of adequate volume resuscitation; no strong evidence of an alternative primary cause.
- Changed in 2024
- The 48-hour albumin challenge is NO LONGER a prerequisite. The consensus recommends against requiring it.
- Also changed
- Proteinuria, microhematuria and abnormal renal ultrasound NO LONGER exclude the diagnosis; HRS-AKI can coexist with tubular injury and chronic kidney disease.
- Why it matters
- A tool still applying the 2015 exclusions will call HRS-AKI absent in patients who have it.
What you enter
- Cirrhosis with ascites
- AKI by creatinine or urine output
- No improvement after volume
- No alternative primary cause
- Proteinuria (does not exclude)
- Microhematuria (does not exclude)
- Abnormal ultrasound (does not exclude)
How this is calculated
Nadim MK, Kellum JA, Forni L, et al. Acute kidney injury in patients with cirrhosis: Acute Disease Quality Initiative and International Club of Ascites joint multidisciplinary consensus meeting. J Hepatol. 2024;81(1):163-183. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.