Have your labs stabilized? And have your doctor's done any micro-anaylisis of your urine? In particular, they will see casts (usually tubular) as your kidneys get damaged by the disturbed portal blood flow. This is basically internal filtering parts of your kidneys breaking down and entering the blood, easily seen and this helps the doctors track down the hepatorenal syndrome progression.
What does you gastroenterologist say?
My BUN and creatinine level have dropped to lower than normal range. I have read that it is rare but seen in severe liver damage. In this case, GFR is not reliable for renal function. Worried! Seems no one experienced.
Hector is correct, as always. I went through the HRS myself, and my numbers were very high, unlike yours. So hopefully you remain healthy!
The blood urea nitrogen or BUN test is primarily used, along with the creatinine test, to evaluate kidney function. Those with advanced cirrhosis may have an impact on kidney function as their liver function progressively fails. This is why the creatinine level is one the the blood tests that make up the MELD score that determines the need for liver transplantation.
Typically when a patient experiences Hepatorenal Syndrome as a result of cirrhosis a HIGH creatinine level is seen.
(Low glomerular filtration rate, indicated by serum creatinine level > 1.5 mg per dL (130 μmol per L) or creatinine clearance < 40 mL per minute (0.67 mL per second).
Like many other complications arising from cirrhosis, kidney issues are the result of the portal hypertension that is the result of the scarring of the liver causing abnormalities in normal blood flow around the liver. In this case effecting the kidneys.
Renal failure is a very common, severe complication in patients with decompensated cirrhosis and is a risk factor for a poor outcome of liver transplantation. Recently introduced therapies have demonstrated efficacy in t he prevent ion and management of the hepatorenal syndrome, a particularly severe form of renal failure characteristic of cirrhosis. Use of these therapies in patients awaiting liver transplantation may help improve the outcome after transplantation.
Luckily liver transplant doctors are very experienced with these issues and are very good at determining which people may need a liver AND kidney transplant and those who kidneys will "bounce back" once a new fully functioning liver is transplanted in the recipient.
Please talk to your liver doctor (gastroenterologist or hepatologist) to learn more about what these tests results may mean in the context of your health and liver disease.
Hector