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Acute kidney injury and hepatorenal syndrome in cirrhosis
Author(s) -
Egerod Israelsen Mads,
Gluud Lise Lotte,
Krag Aleksander
Publication year - 2015
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12709
Subject(s) - hepatorenal syndrome , medicine , terlipressin , transjugular intrahepatic portosystemic shunt , cirrhosis , ascites , acute kidney injury , gastroenterology , liver transplantation , spontaneous bacterial peritonitis , renal function , intensive care medicine , portal hypertension , transplantation
Cirrhosis is the eighth leading cause of “years of lost life” in the U nited S tates and accounts for approximately 1% to 2% of all deaths in E urope. 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.