Monitoring Renal Function and Therapy of Hepatorenal Syndrome Patients with Cirrhosis

Clin Liver Dis. 2021 May;25(2):441-460. doi: 10.1016/j.cld.2021.01.011. Epub 2021 Mar 11.

Abstract

Acute kidney injury (AKI) is a frequent complication in patients with cirrhosis. Patients with cirrhosis can develop AKI due to different causes. Hepatorenal syndrome (HRS) is a unique cause of AKI occurring in patients with advanced cirrhosis and is associated with high short-term mortality. The differential diagnosis between different causes of AKI may be challenging. In this regard, new urine biomarkers may be helpful. Liver transplantation is the definitive treatment of patients with HRS-AKI. Vasoconstrictors and albumin represent the first-line pharmacologic treatment of HRS-AKI. This review summarizes current knowledge for the diagnosis and management of HRS in cirrhosis.

Keywords: Acute kidney injury; Biomarkers; Cirrhosis; Hepatorenal syndrome; Liver transplantation; Terlipressin.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acute Kidney Injury* / diagnosis
  • Acute Kidney Injury* / etiology
  • Acute Kidney Injury* / therapy
  • Hepatorenal Syndrome* / diagnosis
  • Hepatorenal Syndrome* / etiology
  • Hepatorenal Syndrome* / therapy
  • Humans
  • Kidney / physiology
  • Liver Cirrhosis / complications
  • Liver Transplantation*
  • Vasoconstrictor Agents / therapeutic use

Substances

  • Vasoconstrictor Agents