Advances in the management of renal dysfunction in patients with cirrhosis

Nathalie A. Pena Polanco, Paul Martin, Andres F. Carrion

Research output: Contribution to journalArticlepeer-review

Abstract

Renal dysfunction frequently develops in patients with advanced liver disease. Renal dysfunction in this setting is associated with adverse outcomes and an unfavorable prognosis. Hepatorenal syndrome (HRS), defined as worsening renal function in patients with advanced cirrhosis that can present either acutely (<3 months) or more indolently in the absence of other etiologies, remains a common cause of acute kidney injury. If reversal is not promptly achieved, rapid decline to mortality is common. Volume expansion and vasoconstrictors are the mainstays of therapy. Terlipressin, a vasopressin analogue licensed in several countries but not in the United States, is currently used for the treatment of HRS. Timely liver transplantation remains the only effective therapeutic option for a large group of patients with persistent renal dysfunction despite pharmacotherapy. In patients with underlying chronic renal dysfunction, simultaneous liver-kidney transplantation should be considered. The aim of this article is to present an overview of renal dysfunction in patients with cirrhosis, including diagnosis and management.

Original languageEnglish (US)
Pages (from-to)211-220
Number of pages10
JournalGastroenterology and Hepatology
Volume17
Issue number5
StatePublished - May 2021

Keywords

  • Acute kidney injury
  • Chronic kidney disease
  • Cirrhosis
  • Liver disease
  • Renal dysfunction
  • Terlipressin

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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