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Acute kidney injury spectrum in patients with chronic liver disease:Where do we stand? 被引量:15
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作者 Wiwat Chancharoenthana Asada Leelahavanichkul 《World Journal of Gastroenterology》 SCIE CAS 2019年第28期3684-3703,共20页
Acute kidney injury (AKI) is a common complication of liver cirrhosis and is of the utmost clinical and prognostic relevance. Patients with cirrhosis, especially decompensated cirrhosis, are more prone to develop AKI ... Acute kidney injury (AKI) is a common complication of liver cirrhosis and is of the utmost clinical and prognostic relevance. Patients with cirrhosis, especially decompensated cirrhosis, are more prone to develop AKI than those without cirrhosis. The hepatorenal syndrome type of AKI (HRS–AKI), a spectrum of disorders in prerenal chronic liver disease, and acute tubular necrosis (ATN) are the two most common causes of AKI in patients with chronic liver disease and cirrhosis. Differentiating these conditions is essential due to the differences in treatment. Prerenal AKI, a more benign disorder, responds well to plasma volume expansion, while ATN requires more specific renal support and is associated with substantial mortality. HRS–AKI is a facet of these two conditions, which are characterized by a dysregulation of the immune response. Recently, there has been progress in better defining this clinical entity, and studies have begun to address optimal care. The present review synopsizes the current diagnostic criteria, pathophysiology, and treatment modalities of HRS–AKI and as well as AKI in other chronic liver diseases (non-HRS–AKI) so that early recognition of HRS–AKI and the appropriate management can be established. 展开更多
关键词 ACUTE kidney injury Acute-on-chronic LIVER failure Chronic LIVER disease Hepatorenal syndrome plasma perfusion and bilirubin adsorption and double plasma MOLECULAR absorption SYSTEM fractionated plasma separation and adsorption MOLECULAR adsorbent recycling SYSTEM Single-pass albumin dialysis
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