Objective To investigate the risk factors of developing hepatorenal syndrome in patients with severe hepatitis to aid in design and implementation of preventive and early therapeutic strategies.Methods A total of 145 patients treated for severe hepatitis at our hospital between 2008 and 2011 were retrospectively analyzed.Laboratory indicators and complications were analyzed by Chi-squared test and multivariate logistic regression.Results The prevalence rate of hepatorenal syndrome among severe hepatitis patients was 28.3% (41/145) .Logistic regression analysis indicated that the risk factors of hepatorenal syndrome in patients with severe hepatitis were presence of ascites (odds ratio (OR) =9.02, 95% confidence interval (CI) : 1.30-62.79) and perturbed levels of serum urea nitrogen (OR=1.52, 95% CI: 1.13-2.07) , serum creatinine (OR=1.12, 95% CI: 1.09-1.16) , and ammonia (OR=1.05, 95% CI: 1.03-1.08) .Conclusion The prevalence rate of hepatorenal syndrome among severe hepatitis patients is high.Ascite formation, and levels of serum urea nitrogen, serum creatinine, and ammonia should be monitored regularly in patients with severe hepatitis to prevent and initiate early intervention to treat hepatorenal syndrome.