Latest Treatment of Acute Kidney Injury in Cirrhosis
Purpose of review To discuss the latest on the definition of acute kidney injury (AKI), its pathophysiology and treatment of the condition. Recent findings AKI in cirrhosis includes both functional and structural causes. Type 1 hepatorenal syndrome is a special form of functional AKI (HRS-AKI) associated with a very poor prognosis. The pathophysiology of AKI involves hemodynamic changes as well as inflammation. The treatment for AKI is mostly designed for HRS-AKI using albumin and vasoconstrictors to improve systemic hemodynamics, hence renal perfusion and function, resulting in a response rate of up to 44%. Otherwise, patients will need liver transplant as a definitive treatment, with combined liver kidney transplant reserved for patients with a prolonged history of AKI, underlying chronic kidney disease or hereditary renal conditions. Summary Early treatment of HRS-AKI improves chance of response. Future development of biomarkers may help to identify patients for early treatment..
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:18 |
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| Enthalten in: |
Current treatment options in gastroenterology - 18(2020), 2 vom: 15. Mai, Seite 281-294 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Wong, Florence [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Themen: |
Acute-on-chronic liver failure |
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| Anmerkungen: |
© Springer Science+Business Media, LLC, part of Springer Nature 2020 |
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| doi: |
10.1007/s11938-020-00292-0 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
OLC2029127388 |
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| 520 | |a Purpose of review To discuss the latest on the definition of acute kidney injury (AKI), its pathophysiology and treatment of the condition. Recent findings AKI in cirrhosis includes both functional and structural causes. Type 1 hepatorenal syndrome is a special form of functional AKI (HRS-AKI) associated with a very poor prognosis. The pathophysiology of AKI involves hemodynamic changes as well as inflammation. The treatment for AKI is mostly designed for HRS-AKI using albumin and vasoconstrictors to improve systemic hemodynamics, hence renal perfusion and function, resulting in a response rate of up to 44%. Otherwise, patients will need liver transplant as a definitive treatment, with combined liver kidney transplant reserved for patients with a prolonged history of AKI, underlying chronic kidney disease or hereditary renal conditions. Summary Early treatment of HRS-AKI improves chance of response. Future development of biomarkers may help to identify patients for early treatment. | ||
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