Kidney Replacement Therapy in Patients with Acute Liver Failure and End-Stage Cirrhosis Awaiting Liver Transplantation

Karthik Kovvuru; Juan Carlos Q Velez

doi:10.1016/j.cld.2022.01.003

Kidney Replacement Therapy in Patients with Acute Liver Failure and End-Stage Cirrhosis Awaiting Liver Transplantation

Clin Liver Dis. 2022 May;26(2):245-253. doi: 10.1016/j.cld.2022.01.003. Epub 2022 Apr 1.

Authors

Karthik Kovvuru¹, Juan Carlos Q Velez²

Affiliations

¹ Department of Nephrology, Ochsner Health, New Orleans, LA, USA; The University of Queensland/Ochsner Clinical School, Brisbane, Queensland, Australia. Electronic address: Karthikreddy.999@gmail.com.
² Department of Nephrology, Ochsner Health, New Orleans, LA, USA; The University of Queensland/Ochsner Clinical School, Brisbane, Queensland, Australia.

PMID: 35487608
DOI: 10.1016/j.cld.2022.01.003

Abstract

Providing dialysis to patients with liver failure is challenging because of their tenuous hemodynamics and refractory ascites. With better machinery and increased availability, continuous kidney replacement therapy has been successfully delivered to acutely ill patients in liver failure over the past few decades. Intermittent hemodialysis continues to remain the modality of choice outside the intensive care unit and on occasion needs to be complemented with paracentesis. Peritoneal dialysis has not been widely used, but recent literature shows promising outcomes barring for publication bias. Albumin dialysis could be a lifesaving procedure for a carefully selected subgroup of patients with liver failure.

Keywords: Ascites; Cirrhosis; Dialysis; End-stage cirrhosis; Kidney Replacement Therapy; Liver Failure; Liver Transplantation; Peritoneal Dialysis; Renal Replacement Therapy.

Publication types

Review

MeSH terms

Humans
Liver Cirrhosis / complications
Liver Failure* / etiology
Liver Failure, Acute* / etiology
Liver Failure, Acute* / surgery
Liver Transplantation* / adverse effects
Renal Replacement Therapy