Acute kidney injury and hepatorenal syndrome in cirrhosis

TY - JOUR

T1 - Acute kidney injury and hepatorenal syndrome in cirrhosis

AU - Egerod Israelsen, Mads

AU - Gluud, Lise Lotte

AU - Krag, Aleksander

N1 - © 2014 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

PY - 2015/2/1

Y1 - 2015/2/1

N2 - Cirrhosis is the eighth leading cause of "years of lost life" in the United States and accounts for approximately 1% to 2% of all deaths in Europe. Patients with cirrhosis have a high risk of developing acute kidney injury. The clinical characteristics of hepatorenal syndrome (HRS) are similar to prerenal uremia, but the condition does not respond to volume expansion. HRS type 1 is rapidly progressive whereas HRS type 2 has a slower course often associated with refractory ascites. A number of factors can precipitate HRS such as infections, alcoholic hepatitis, and bleeding. The monitoring, prevention, early detection, and treatment of HRS are essential. This paper reviews the value of early evaluation of renal function based on two new sets of diagnostic criteria. Interventions for HRS type 1 include terlipressin combined with albumin. In HRS type 2, transjugular intrahepatic portosystemic shunt (TIPS) should be considered. For both types of HRS patients should be evaluated for liver transplantation.

AB - Cirrhosis is the eighth leading cause of "years of lost life" in the United States and accounts for approximately 1% to 2% of all deaths in Europe. Patients with cirrhosis have a high risk of developing acute kidney injury. The clinical characteristics of hepatorenal syndrome (HRS) are similar to prerenal uremia, but the condition does not respond to volume expansion. HRS type 1 is rapidly progressive whereas HRS type 2 has a slower course often associated with refractory ascites. A number of factors can precipitate HRS such as infections, alcoholic hepatitis, and bleeding. The monitoring, prevention, early detection, and treatment of HRS are essential. This paper reviews the value of early evaluation of renal function based on two new sets of diagnostic criteria. Interventions for HRS type 1 include terlipressin combined with albumin. In HRS type 2, transjugular intrahepatic portosystemic shunt (TIPS) should be considered. For both types of HRS patients should be evaluated for liver transplantation.

KW - Acute Kidney Injury

KW - Albumins

KW - Ascites

KW - Disease Progression

KW - Drug Therapy, Combination

KW - Early Diagnosis

KW - Hepatorenal Syndrome

KW - Humans

KW - Liver Cirrhosis

KW - Liver Transplantation

KW - Lypressin

KW - Portasystemic Shunt, Transjugular Intrahepatic

U2 - 10.1111/jgh.12709

DO - 10.1111/jgh.12709

M3 - Review

C2 - 25160511

SN - 0815-9319

VL - 30

SP - 236

EP - 243

JO - Journal of Gastroenterology and Hepatology

JF - Journal of Gastroenterology and Hepatology

IS - 2

ER -