Acute kidney injury and hepatorenal syndrome in end-stage liver disease / 临床肝胆病杂志

ABSTRACT

Acute kidney injury (AKI) and hepatorenal syndrome (HRS) are serious complications in patients with end-stage liver disease, with renal injury as the main manifestation. They are interrelated, but also different from each other. There are several types of AKI, i.e., prerenal AKI, intrarenal or intrinsic AKI, and post-renal AKI, and type 1 HRS is considered a special type of AKI. There are different therapies for different types of AKI. With the improvement in the diagnostic criteria for AKI and chronic kidney disease in recent years, the diagnostic criteria and classification of HRS have also been updated. As for pathogenesis, systemic inflammation caused by intestinal bacterial translocation is attracting more and more attention. HRS was considered functional renal injury in the past, but recent evidence suggests the existence of structural injury. Vasoconstrictor combined with albumin is the main therapeutic drug for HRS. This article reviews the diagnosis and treatment of AKI in end-stage liver disease and the recent advances in the diagnostic criteria, classification, pathology, pathogenesis, and treatment of HRS.