Kidney Injury in Liver Disease

Crit Care Clin. 2016 Jul;32(3):343-55. doi: 10.1016/j.ccc.2016.03.005.

Abstract

Acute kidney injury (AKI) occurs frequently in patients with liver disease and increases morbidity and mortality. Hepatorenal syndrome is a common cause of AKI in patients with decompensated cirrhosis and is due to alterations in systemic and renal hemodynamics. Serum creatinine-based estimation of kidney function is a key component of the Model for End-stage Liver Disease score in liver transplant candidates. Continuous renal replacement therapy is used in critically ill patients with liver failure and AKI. Simultaneous liver-kidney transplantation (SLK) may be required in patients with liver failure and prolonged AKI. Identification of appropriate candidates for SLK remains controversial.

Keywords: Acute kidney injury; Cirrhosis; Hepatorenal syndrome; Liver transplant.

Publication types

  • Review

MeSH terms

  • Acidosis / diagnosis
  • Acidosis / etiology*
  • Acidosis / therapy
  • Acute Kidney Injury / epidemiology
  • Acute Kidney Injury / etiology
  • Acute Kidney Injury / physiopathology*
  • Acute Kidney Injury / therapy
  • Chronic Disease
  • Hepatorenal Syndrome / diagnosis
  • Hepatorenal Syndrome / epidemiology
  • Hepatorenal Syndrome / etiology
  • Hepatorenal Syndrome / therapy
  • Humans
  • Kidney Transplantation
  • Liver Diseases / complications*
  • Liver Diseases / therapy
  • Liver Failure, Acute / complications
  • Liver Transplantation
  • Renal Replacement Therapy* / methods