Renal dysfunction in cirrhosis

Current Opinion in Gastroenterology
Nathalie H UrrunagaDon C Rockey

Abstract

Renal dysfunction causes significant morbidity in cirrhotic patients. Diagnosis is challenging because it is based on serum creatinine, which is used to calculate estimated glomerular filtration rate, which itself is not an ideal measure of renal function in patients with cirrhosis. Finding the exact cause of renal injury in patients with cirrhosis remains problematic due to the limitations of the current diagnostic tests. The purpose of this review is to highlight studies used to diagnose renal dysfunction in patients with renal dysfunction and review current treatments. New diagnostic criteria and classification of renal dysfunction, especially for acute kidney injury (AKI), have been proposed in hopes of optimizing treatment and improving outcomes. New biomarkers that help to differentiate structural from functional AKI in cirrhotic patients have been developed, but require further investigation. Vasoconstrictors are the most commonly recommended treatment of hepatorenal syndrome (HRS). Given the high mortality in patients with type 1 HRS, all patients with HRS should be evaluated for liver transplantation. When renal dysfunction is considered irreversible, combined liver-kidney transplantation is advised. Development of new...Continue Reading

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Citations

Mar 19, 2016·Hepatology Research : the Official Journal of the Japan Society of Hepatology·Takefumi MoriSadayoshi Ito
May 31, 2018·Current Opinion in Gastroenterology·Mona Haj, Don C Rockey
Mar 3, 2018·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Akash DeepBipin Jose
Apr 3, 2020·Journal of Applied Physiology·Annette BellarSrinivasan Dasarathy
Oct 20, 2021·Clinica Chimica Acta; International Journal of Clinical Chemistry·Pooja Basthi MohanShiran Shetty

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Methods Mentioned

BETA
urine collection

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