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Review
. 2021 Mar;9(2):220-228.
doi: 10.1177/2050640620980713. Epub 2021 Feb 16.

Global strategy for the diagnosis and management of acute kidney injury in patients with liver cirrhosis

Lukas Otero Sanchez  1   2 , Claire Francoz  3   4
Affiliations
Review

Global strategy for the diagnosis and management of acute kidney injury in patients with liver cirrhosis

Lukas Otero Sanchez et al. United European Gastroenterol J. 2021 Mar.

Abstract

Acute kidney injury (AKI) is a clinical syndrome that complicates the course and worsens clinical outcomes in patients with chronic liver diseases. It is a common complication in hospitalised patients with liver cirrhosis, especially those with decompensated cirrhosis, associated with a high mortality rate. Considering its impact on patient prognosis, efforts should be made to diagnose and tailor therapeutic interventions for AKI at an early stage. In the past decade, a significant progress has been made to understand the key events and define major prognostic factors for the onset and progression of AKI in the cirrhotic population leading hepatologists to redefine the classic definition of hepatorenal syndrome and renal failure in this specific population.

Keywords: acute kidney injury; chronic liver diseases; decompensated cirrhosis; hepatorenal syndrome; liver transplantation.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
Diagnostic approach of acute kidney injury in patients with cirrhosis. ACLF, acute‐on‐chronic liver failure; AKI, acute kidney injury; ALF, acute liver failure
FIGURE 2
FIGURE 2
Diagnostic criteria of HRS‐AKI. NSAIDs, non‐steroidal anti‐inflammatory drugs; sCr, serum creatinine
FIGURE 3
FIGURE 3
Algorithm for the management of acute kidney injury acute kidney injury in patients with cirrhosis. *Return of sCr to a value within 0.3 mg/ml (26.5 μmol/L) from baseline; **Specific diseases such as acute glomerulopathies or acute vascular diseases may require specific treatments discussed with nephrologist. In contrast, there is no specific treatment for acute tubular necrosis
See this image and copyright information in PMC

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