Cargando…

Acute kidney injury spectrum in patients with chronic liver disease: Where do we stand?

Acute kidney injury (AKI) is a common complication of liver cirrhosis and is of the utmost clinical and prognostic relevance. Patients with cirrhosis, especially decompensated cirrhosis, are more prone to develop AKI than those without cirrhosis. The hepatorenal syndrome type of AKI (HRS–AKI), a spe...

Descripción completa

Detalles Bibliográficos
Autores principales: Chancharoenthana, Wiwat, Leelahavanichkul, Asada
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676545/
https://www.ncbi.nlm.nih.gov/pubmed/31391766
http://dx.doi.org/10.3748/wjg.v25.i28.3684
_version_ 1783440783862398976
author Chancharoenthana, Wiwat
Leelahavanichkul, Asada
author_facet Chancharoenthana, Wiwat
Leelahavanichkul, Asada
author_sort Chancharoenthana, Wiwat
collection PubMed
description Acute kidney injury (AKI) is a common complication of liver cirrhosis and is of the utmost clinical and prognostic relevance. Patients with cirrhosis, especially decompensated cirrhosis, are more prone to develop AKI than those without cirrhosis. The hepatorenal syndrome type of AKI (HRS–AKI), a spectrum of disorders in prerenal chronic liver disease, and acute tubular necrosis (ATN) are the two most common causes of AKI in patients with chronic liver disease and cirrhosis. Differentiating these conditions is essential due to the differences in treatment. Prerenal AKI, a more benign disorder, responds well to plasma volume expansion, while ATN requires more specific renal support and is associated with substantial mortality. HRS–AKI is a facet of these two conditions, which are characterized by a dysregulation of the immune response. Recently, there has been progress in better defining this clinical entity, and studies have begun to address optimal care. The present review synopsizes the current diagnostic criteria, pathophysiology, and treatment modalities of HRS–AKI and as well as AKI in other chronic liver diseases (non-HRS–AKI) so that early recognition of HRS–AKI and the appropriate management can be established.
format Online
Article
Text
id pubmed-6676545
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Baishideng Publishing Group Inc
record_format MEDLINE/PubMed
spelling pubmed-66765452019-08-07 Acute kidney injury spectrum in patients with chronic liver disease: Where do we stand? Chancharoenthana, Wiwat Leelahavanichkul, Asada World J Gastroenterol Opinion Review Acute kidney injury (AKI) is a common complication of liver cirrhosis and is of the utmost clinical and prognostic relevance. Patients with cirrhosis, especially decompensated cirrhosis, are more prone to develop AKI than those without cirrhosis. The hepatorenal syndrome type of AKI (HRS–AKI), a spectrum of disorders in prerenal chronic liver disease, and acute tubular necrosis (ATN) are the two most common causes of AKI in patients with chronic liver disease and cirrhosis. Differentiating these conditions is essential due to the differences in treatment. Prerenal AKI, a more benign disorder, responds well to plasma volume expansion, while ATN requires more specific renal support and is associated with substantial mortality. HRS–AKI is a facet of these two conditions, which are characterized by a dysregulation of the immune response. Recently, there has been progress in better defining this clinical entity, and studies have begun to address optimal care. The present review synopsizes the current diagnostic criteria, pathophysiology, and treatment modalities of HRS–AKI and as well as AKI in other chronic liver diseases (non-HRS–AKI) so that early recognition of HRS–AKI and the appropriate management can be established. Baishideng Publishing Group Inc 2019-07-28 2019-07-28 /pmc/articles/PMC6676545/ /pubmed/31391766 http://dx.doi.org/10.3748/wjg.v25.i28.3684 Text en ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Opinion Review
Chancharoenthana, Wiwat
Leelahavanichkul, Asada
Acute kidney injury spectrum in patients with chronic liver disease: Where do we stand?
title Acute kidney injury spectrum in patients with chronic liver disease: Where do we stand?
title_full Acute kidney injury spectrum in patients with chronic liver disease: Where do we stand?
title_fullStr Acute kidney injury spectrum in patients with chronic liver disease: Where do we stand?
title_full_unstemmed Acute kidney injury spectrum in patients with chronic liver disease: Where do we stand?
title_short Acute kidney injury spectrum in patients with chronic liver disease: Where do we stand?
title_sort acute kidney injury spectrum in patients with chronic liver disease: where do we stand?
topic Opinion Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676545/
https://www.ncbi.nlm.nih.gov/pubmed/31391766
http://dx.doi.org/10.3748/wjg.v25.i28.3684
work_keys_str_mv AT chancharoenthanawiwat acutekidneyinjuryspectruminpatientswithchronicliverdiseasewheredowestand
AT leelahavanichkulasada acutekidneyinjuryspectruminpatientswithchronicliverdiseasewheredowestand