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Question category: Nephrology

A patient is admitted with decompensated liver disease and tense ascites. His bloods reveal an acute renal failure. He is not on any nephrotoxic drugs. He had been previously on spironolactone and furosemide for prophylaxis of ascites however these were stopped some months ago. His blood pressure is 130/80 mmHg and his renal failure does not respond to fluids. A urinalysis shows a trace amount of protein but nil else. An ultrasound of the renal tract shows no evidence of obstruction. What is the most likely diagnosis?

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