Acute kidney injury in patients with liver diseases Aleksandra Rymarz, Urszula Ołdakowska-Jedynak, Marek Krawczyk Medical Science Review - Hepatologia 2009; 9 40-45 aaICID: 902240
Article type: Review article
IC™ Value: 3.04
Abstract provided by Publisher
Acute kidney injury (AKI) affects 20% of hospitalized patients with cirrhosis and is associated with poor outcome. According to RIFLE criteria, a diagnosis of AKI should be made when serum creatinine level rises suddenly by 0.3 mg/dl or more or increases by 150% or more from baseline. The most frequent type of AKI is prerenal azotemia with its specific disorder hepatorenal syndrome (HRS). HRS is a functional type of AKI, potentially reversible, caused by renal vasoconstriction secondary to splanchnic and systemic vasodilatation. It can occur spontaneously, but is often associated with events which worsen vasodilatation, such as spontaneous bacterial peritonitis (SBP). Renal azotemia is less frequent and is mainly represented by acute tubular necrosis (ATN). ATN can be toxic or ischemic in origin. All causes of prerenal azotemia can lead to ATN. Injury of renal tubules can occur after administration of aminoglycoside antibiotics or radiocontrast agent. Treatment of AKI depends on factors which lead to kidney injury. Early treatment of hepatorenal syndrome by vasoconstrictors and albumin infusion can resolve renal impairment and is a bridging therapy to liver transplantation.