Acute kidney injury and hepatorenal syndrome in cirrhosis

被引：32

作者：

Gupta, Kapil ^{[1
]}

Bhurwal, Abhishek ^{[1
]}

Law, Cindy ^{[1
]}

Ventre, Scott ^{[2
]}

Minacapelli, Carlos D. ^{[1
]}

Kabaria, Savan ^{[2
]}

Li, You ^{[1
]}

Tait, Christopher ^{[1
]}

Catalano, Carolyn ^{[1
]}

Rustgi, Vinod K. ^{[1
]}

机构：

[1] Rutgers Robert Wood Johnson Med Sch, Div Gastroenterol & Hepatol, 1 Robert Wood Johnson Pl,Med Educ Bldg,Rm 479, New Brunswick, NJ 08901 USA

[2] Rutgers Robert Wood Johnson Med Sch, Dept Internal Med, New Brunswick, NJ 08901 USA

来源：

WORLD JOURNAL OF GASTROENTEROLOGY | 2021年 / 27卷 / 26期

关键词：

Acute kidney injury; Hepatorenal syndrome; Liver cirrhosis; Treatment; Biomarkers; Prognosis; SPONTANEOUS BACTERIAL PERITONITIS; GELATINASE-ASSOCIATED LIPOCALIN; TERLIPRESSIN PLUS ALBUMIN; CHRONIC LIVER-FAILURE; ACUTE-RENAL-FAILURE; ADSORBENT RECIRCULATING SYSTEM; INFLAMMATORY RESPONSE SYNDROME; GLOMERULAR-FILTRATION-RATE; ACID-BINDING PROTEIN; HOSPITALIZED-PATIENTS;

D O I：

10.3748/wjg.v27.i26.3984

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Acute kidney injury (AKI) in cirrhosis, including hepatorenal syndrome (HRS), is a common and serious complication in cirrhotic patients, leading to significant morbidity and mortality. AKI is separated into two categories, non-HRS AKI and HRS-AKI. The most recent definition and diagnostic criteria of AKI in cirrhosis and HRS have helped diagnose and prognosticate the disease. The pathophysiology behind non-HRS-AKI and HRS is more complicated than once theorized and involves more processes than just splanchnic vasodilation. The common biomarkers clinicians use to assess kidney injury have significant limitations in cirrhosis patients; novel biomarkers being studied have shown promise but require further studies in clinical settings and animal models. The overall management of non-HRS AKI and HRS-AKI requires a systematic approach. Although pharmacological treatments have shown mortality benefit, the ideal HRS treatment option is liver transplantation with or without simultaneous kidney transplantation. Further research is required to optimize pharmacologic and nonpharmacologic approaches to treatment. This article reviews the current guidelines and recommendations of AKI in cirrhosis.

引用

页码：3984 / 4003

页数：20

共 153 条

[1] Relative Adrenal Insufficiency in Decompensated Cirrhosis: Relationship to Short-Term Risk of Severe Sepsis, Hepatorenal Syndrome, and Death [J].