The evolving concept of acute kidney injury in patients with cirrhosis

Acute kidney injury (AKI) in cirrhosis consists of a spectrum of diseases, some related to abnormalities in renal function, whereas others are related to renal damageThe International Club of Ascites defined AKI in cirrhosis by small changes in serum creatinine and has defined staging, progression and response to treatmentAcute or type 1 hepatorenal syndrome (HRS) is now known as HRS-AKI, whereas chronic type 2 HRS is now known as HRS chronic kidney diseaseThe new AKI definition allows patients with persistent doubling of serum creatinine despite albumin and diuretic withdrawal who otherwise fulfil the diagnostic criteria for hepatorenal syndrome to receive pharmacotherapyThe use of biomarkers of renal functional changes and structural damage might enhance our ability to assess risk, diagnose AKI and provide a prognosis for patientsNew knowledge of the pathophysiology of AKI in patients with liver cirrhosis could lead to further refinement of our definition of AKI for cirrhosis in the future