Cirrhosis and renal dysfunction

Abstract

Renal dysfunction in patients with cirrhosis causes significant morbidity, and clinically appears as acute kidney injury (AKI), chronic renal failure (CRF), and CRF on AKI. The main causes of renal dysfunction are prerenal azotemia, intrinsic renal failure, hepatorenal syndrome and postrenal disease. Serum creatinine and creatinine clearance are among the most commonly used parameters for the diagnosis. Avoidance of nephrotoxic agents, albumin infusion, vasoconstrictor agents, vaptan derivatives, and dialysis options including albumin are the basic treatment approaches. Liver transplantation should be considered in patients with advanced liver disease and all hepatorenal syndrome cases. After development of advanced liver failure, patients with continuing kidney failure over three months and special indications can be considered for combined liver and kidney transplantations. In this article, we reviewed the current information on kidney dysfunction in cirrhotic patients.