Acute kidney injury and hepatorenal syndrome in cirrhosis

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Cirrhosis is the eighth leading cause of "years of lost life" in the United States and accounts for approximately 1% to 2% of all deaths in Europe. Patients with cirrhosis have a high risk of developing acute kidney injury. The clinical characteristics of hepatorenal syndrome (HRS) are similar to prerenal uremia, but the condition does not respond to volume expansion. HRS type 1 is rapidly progressive whereas HRS type 2 has a slower course often associated with refractory ascites. A number of factors can precipitate HRS such as infections, alcoholic hepatitis, and bleeding. The monitoring, prevention, early detection, and treatment of HRS are essential. This paper reviews the value of early evaluation of renal function based on two new sets of diagnostic criteria. Interventions for HRS type 1 include terlipressin combined with albumin. In HRS type 2, transjugular intrahepatic portosystemic shunt (TIPS) should be considered. For both types of HRS patients should be evaluated for liver transplantation.

Original languageEnglish
JournalJournal of Gastroenterology and Hepatology
Volume30
Issue number2
Pages (from-to)236–243
ISSN0815-9319
DOIs
Publication statusPublished - Feb 2015

Keywords

  • Acute kidney injury
  • Acute-on-chronic liver failure
  • Adrenal insufficiency
  • Cirrhosis
  • Cirrhotic cardiomyopathy
  • Hepatorenal syndrome
  • Liver Cirrhosis/complications
  • Liver Transplantation
  • Acute Kidney Injury/classification
  • Ascites/etiology
  • Humans
  • Disease Progression
  • Terlipressin
  • Albumins/administration & dosage
  • Drug Therapy, Combination
  • Portasystemic Shunt, Transjugular Intrahepatic
  • Early Diagnosis
  • Hepatorenal Syndrome/classification
  • Lypressin/administration & dosage

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