Response to Terlipressin in Hepatorenal Syndrome: Predict to Prognosticate!

I read with great interest the review article published recently by Mindikoglu et al1 and would like to congratulate the authors on their eloquent update on hepatorenal syndrome (HRS). As pointed out distinctly, HRS continues to be a significant problem faced by clinicians who are actively involved in managing patients with advanced liver disease with ascites. HRS type 1 is a type of rapidly progressive acute kidney injury and is associated with a median survival of only approximately 4 weeks. It thus becomes extremely crucial to predict the subset of patients who are likely to be nonresponsive to vasoconstrictor therapy, which would help treating clinicians to accurately prognosticate and counsel the patient and plan simultaneously for an early liver transplant.

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