Towards norepinephrine as first line treatment for all hospitalized patients with HRS.

Hepatorenal syndrome (HRS) is a devastating complication of advanced liver disease associated with high mortality. Despite having been described as a clinical syndrome more than 60 years ago, options for the treatment of HRS remain very limited. Medical management of patients with HRS, either those waiting for definitive treatment with liver transplantation or those for whom transplantation is not an option, typically includes administration of albumin in combination with vasoconstrictor therapy.