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[Dilutional hyponatremia, hepatorenal syndrome and liver transplantation].

Cirrhosis is a chronic, progressive disease characterized by complications associated with portal hypertension and liver failure. Renal function disorders are a common complication in patients with cirrhosis and are associated with high morbidity and mortality and poor prognosis. Renal function alterations in these patients include sodium and water retention and renal vasoconstriction. Sodium retention causes the formation of ascites and edema, solute-free water leads to dilutional hyponatremia, and renal vasoconstriction gives rise to the development of hepatorenal syndrome (HRS). Due to their poor prognosis, the presence of ascites, dilutional hyponatremia and HRS are indications for liver transplantation (LT). Recent studies have allowed new prognostic factors in these patients to be identified, novel treatments for dilutional hyponatremia and HRS to be applied, and the association of these complications with disease course and outcome before and after LT to be described. The present review discusses new concepts of the physiopathology, evaluation and treatment of cirrhotic patients with dilutional hyponatremia and HRS and the relationship of these entities with LT.