Liver Cirrhosis and Kidney

Abstract

Background: Renal failure in cirrhosis may be due to various causes. While treatment for patients with ascites and hepatorenal syndrome is established, recent attention has been focused on acute kidney injury (AKI) in cirrhosis.

Key messages: The reduction of centrally effective blood volume is the key to the pathophysiology of renal failure and ascites formation in cirrhosis. Therefore, albumin infusion following large volume paracentesis is recommended by all guidelines. In selected patients, transjugular intrahepatic portosystemic shunt provides good control of ascites and improves survival. The role of non-selective beta-blockers in patients with cirrhosis and ascites is being controversially discussed. AKI in cirrhosis has been redefined and has prognostic importance.

Conclusions: The role of kidney function in patients with liver cirrhosis is receiving increasing attention. In particular, the use of beta-blockers and novel definitions of AKI seem to be of clinical relevance.