(1462413-02) Acute Kidney Injury in Cirrhosis: Think Broadly and Exclude Other Causes Before Anchoring to Hepatorenal Syndrome

AKI is commonly encountered in patients with decompensated cirrhosis and is associated with increased morbidity, mortality, and adverse long-term outcomes. Among factors specific to cirrhosis, hepatorenal syndrome-AKI (HRS-AKI), is the most salient and unique etiology. At the same time, patients with cirrhosis are equally vulnerable to traditional causes of AKI. This section will focus on a comprehensive evaluation of traditional causes of AKI including prerenal azotemia, acute glomerulonephritis, acute tubular injury, acute interstitial nephritis, etiologies related to cirrhosis including abdominal compartment syndrome, cardiorenal processes due to cirrhotic cardiomyopathy and portopulmonary hypertension and HRS-AKI.

Russ KB, Stevens TM, Singal AK. Acute Kidney Injury in Patients with Cirrhosis. J Clin Transl Hepatol. 2015 Sep 28;3(3):195-204. doi: 10.14218/JCTH.2015.00015. Epub 2015 Sep 15. PMID: 26623266; PMCID: PMC4663201

Chancharoenthana W, Leelahavanichkul A. Acute kidney injury spectrum in patients with chronic liver disease: Where do we stand? World J Gastroenterol. 2019 Jul 28;25(28):3684-3703. doi: 10.3748/wjg.v25.i28.3684. PMID: 31391766; PMCID: PMC6676545.

Wong, F MD; O'Leary, J G MD; Reddy, K R MD; Garcia-Tsao, G MD; Fallon, M B MD; Biggins, S W MD, MS; Subramanian, R M MD; Thuluvath, P J MD; Kamath, P S MD; Patton, H MD; Maliakkal, B MD; Tandon, P MD; Vargas, H MD; Thacker, L PhD; Bajaj, J S MD on behalf of The North American Consortium for the Study of End-Stage Liver Disease (NACSELD). Acute Kidney Injury in Cirrhosis: Baseline Serum Creatinine Predicts Patient Outcomes. American Journal of Gastroenterology 112(7):p 1103-1110, July 2017. | DOI: 10.1038/ajg.2017.122

Cullaro, Giuseppe; Kanduri, Swetha Rani, Velez, Juan Carlos Q. Acute Kidney Injury in Patients with Liver Disease. CJASN 17(11):p 1674-1684, November 2022. | DOI: 10.2215/CJN.03040322