Table 1 International Ascites Club's definition of hepato-renal syndrome

Chronic or acute liver disease with advanced hepatic failure and portal hypertension

Low glomerular filtration rate, as indicated by serum creatinine of more than 1.5 mg dl^-1 or 24-hour creatinine clearance less than 40 ml min^-1

Absence of shock, ongoing bacterial infection, and current or recent treatment with nephrotoxic drugs. Absence of gastrointestinal fluid losses (repeated vomiting or intense diarrhoea) or renal fluid losses (weight loss more than 500 g per day for several days in patients with ascites without peripheral oedema or 1,000 g per day in patients with peripheral oedema)

No sustained improvement in renal function (decrease in serum creatinine to 1.5 mg dl^-1 or less, or increase in creatinine clearance to 40 ml min^-1 or more) after diuretic withdrawal and expansion of plasma volume with 1.5 litres of isotonic saline

Proteinuria less than 500 mg dl^-1 and no ultrasonographic evidence of obstructive uropathy or parenchymal renal disease