Renal Complications in Portal Hypertension

Clin Liver Dis. 2024 Aug;28(3):503-523. doi: 10.1016/j.cld.2024.03.011. Epub 2024 May 22.

Abstract

Acute kidney injury (AKI) is a common complication among patients with decompensated cirrhosis and its development is associated with worse prognosis in terms of survival. Patients with decompensated cirrhosis may develop a unique type of AKI, known as hepatorenal syndrome (HRS-AKI), characterized by marked impairment of kidney function due to haemodynamic changes that occur in late stages of liver cirrhosis. Besides, patients with cirrhosis also may develop chronic alterations of kidney function (chronic kidney disease, CKD), the incidence of which is increasing markedly and may be associated with clinical complications. The aim of this review is to provide the reader with an update of the most relevant aspects of alterations of kidney function in patients with cirrhossi that may be useful for theri clinical practice.

Keywords: Acute kidney injury; Biomarkers; Chronic kidney disease; Cirrhosis; HRS-AKI; Liver transplantation; Terlipressin.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury* / etiology
  • Acute Kidney Injury* / physiopathology
  • Hepatorenal Syndrome* / etiology
  • Hepatorenal Syndrome* / physiopathology
  • Humans
  • Hypertension, Portal* / complications
  • Hypertension, Portal* / etiology
  • Hypertension, Portal* / physiopathology
  • Liver Cirrhosis* / complications
  • Liver Cirrhosis* / physiopathology
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / physiopathology