Abstract: Hepatorenal syndrome （HRS） is a type of cirrhosis-related renal damage with a unique pathophysiological mechanism. HRS-AKI is the subtype that needs special attention. In addition to the classical mechanisms of hemodynamic disorders，the occurrence of HRS-AKI also involves a variety of pathophysiological mechanisms such as intestinal bacterial translocation，systemic inflammation，renal microcirculation disorders and cirrhotic cardiomyopathy and so on. Early diagnosis and treatment can improve the poor prognosis of HRS-AKI. Albumin plus terlipressin is a widely recommended first-line treatment，nevertheless liver transplantation is the only definitive treatment for HRS. This article reviews the new definition，diagnostic and grading criteria，pathogenesis，and treatment of HRS-AKI.

Key words: advanced cirrhosis, hepatorenal syndrome, acute kidney injury, human albumin, terlipressin