Renal dysfunction is a common complication of liver cirrhosis and of utmost clinical and prognostic relevance.Patients with cirrhosis are more prone to developing acute kidney injury(AKI)than the non-cirrhotic populat...Renal dysfunction is a common complication of liver cirrhosis and of utmost clinical and prognostic relevance.Patients with cirrhosis are more prone to developing acute kidney injury(AKI)than the non-cirrhotic population.Pre-renal AKI,the hepatorenal syndrome type of AKI(HRS-AKI,formerly known as‘type 1’)and acute tubular necrosis represent the most common causes of AKI in cirrhosis.Correct differentiation is imperative,as treatment differs substantially.While pre-renal AKI usually responds well to plasma volume expansion,HRS-AKI and ATN require different specific approaches and are associated with substantial mortality.Several paradigms,such as the threshold of 2.5 mg/dL for diagnosis of HRS-AKI,have recently been abolished and novel urinary biomarkers are being investigated in order to facilitate early and correct diagnosis and treatment of HRS-AKI and other forms of AKI in patients with cirrhosis.This review summarizes the current diagnostic criteria,as well as pathophysiologic and therapeutic concepts for AKI and HRS-AKI in cirrhosis.展开更多
文摘Renal dysfunction is a common complication of liver cirrhosis and of utmost clinical and prognostic relevance.Patients with cirrhosis are more prone to developing acute kidney injury(AKI)than the non-cirrhotic population.Pre-renal AKI,the hepatorenal syndrome type of AKI(HRS-AKI,formerly known as‘type 1’)and acute tubular necrosis represent the most common causes of AKI in cirrhosis.Correct differentiation is imperative,as treatment differs substantially.While pre-renal AKI usually responds well to plasma volume expansion,HRS-AKI and ATN require different specific approaches and are associated with substantial mortality.Several paradigms,such as the threshold of 2.5 mg/dL for diagnosis of HRS-AKI,have recently been abolished and novel urinary biomarkers are being investigated in order to facilitate early and correct diagnosis and treatment of HRS-AKI and other forms of AKI in patients with cirrhosis.This review summarizes the current diagnostic criteria,as well as pathophysiologic and therapeutic concepts for AKI and HRS-AKI in cirrhosis.
