摘要
Acute kidney injury(AKI) is a frequent clinical event in patients with liver disease, compounding their prognosis. Furthermore, it is likely that the occurrence of AKI has a detrimental impact on the subsequent renal function and the long-term survival of these patients. Recently, some authors advocated the use of new diagnostic criteria for detecting acute kidney injury in patients with cirrhosis. These criteria are based on the rapidity and extent of the creatinine increase comparing to the basal creatinine and also on the kinetics of diuresis decrease. Although their validity in this population requires further studies to be clearly established, these new criteria could have two advantages:(1) to allow earlier diagnosis of AKI and, thus, hepatorenal syndromefor which earlier intervention could improve patients' survival; and(2) to promote more intensive monitoring of renal function in these patients with high risk of AKI. Finally, recent practice guidelines about the prevention and treatment of general AKI have been published which should be useful in optimising the management of AKI in cirrhotic patients.
Acute kidney injury (AKI) is a frequent clinical event inpatients with liver disease, compounding their prognosis.Furthermore, it is likely that the occurrence of AKI hasa detrimental impact on the subsequent renal functionand the long-term survival of these patients. Recently,some authors advocated the use of new diagnosticcriteria for detecting acute kidney injury in patients withcirrhosis. These criteria are based on the rapidity andextent of the creatinine increase comparing to the basalcreatinine and also on the kinetics of diuresis decrease.Although their validity in this population requiresfurther studies to be clearly established, these newcriteria could have two advantages: (1) to allow earlierdiagnosis of AKI and, thus, hepatorenal syndromefor which earlier intervention could improve patients’survival; and (2) to promote more intensive monitoringof renal function in these patients with high risk of AKI.Finally, recent practice guidelines about the preventionand treatment of general AKI have been publishedwhich should be useful in optimising the managementof AKI in cirrhotic patients.