Insuficiencia renal en la cirrosisformas clínicas y tratamiento

  1. B. Mateos 1
  2. R. Martín-Mateos 1
  3. J.L. Lledó 1
  4. L. Téllez 1
  5. A. Albillos 1
  1. 1 Hospital Ramón y Cajal
    info

    Hospital Ramón y Cajal

    Madrid, España

    ROR https://ror.org/050eq1942

Journal:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Year of publication: 2016

Issue Title: Enfermedades del aparato digestivo (XII) Enfermedades hepáticas. Complicaciones de la cirrosis hepática

Series: 12

Issue: 12

Pages: 698-701

Type: Article

DOI: 10.1016/J.MED.2016.05.024 DIALNET GOOGLE SCHOLAR

More publications in: Medicine: Programa de Formación Médica Continuada Acreditado

Abstract

Introduction Renal dysfunction is a frequent complication in cirrhotic patients and it is an indicator of poor prognosis if it is not identified and treated early. Patients with cirrhosis have multiple risk factors to develop an acute kidney injury. Pathogeny The most common causes of acute kidney injury in cirrhosis are pre-renalazotemia, acute tubular necrosis and type 1 hepatorenal syndrome. Treatment Each type of renal disease has a specific treatment approach ranging from expansion of intravascular volume to renal replacement therapy. The treatment of type 1 hepatorenal syndrome is a combination of vasoconstrictor with albumin, which is effective in about 50% patients. Type 2 hepatorenal syndrome is a more stable renal dysfunction, slowly progressive, and is related with refractory ascites.

Bibliographic References

  • Urrunaga NH, Mindikoglu AL, Rockey DC. Renal dysfunction in cirrhosis. Curr Opin Gastroenterol. 2015;31(3):215-23.
  • Loo NM-M, Souza FF, García-Tsao G. Non-hemorrhagic acute compli-cations associated with cirrhosis and portal hypertension. Best Pract Res Clin Gastroenterol. 2013;27(5):665-78.
  • Baccaro ME, Guevara M. [Hepatorenal syndrome]. Gastroenterol Hepa-tol. 2007;30(9):548-54.
  • European Association for the Study of the Liver. EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis. J Hepatol. 2010;53(3):397-417.
  • Angeli P, Gines P, Wong F, Bernardi M, Boyer TD, Gerbes A, et al. Diagnosis and management of acute kidney injury in patients with cirrhosis: revised consensus recommendations of the Interna-tional Club of Ascites. Gut. 2015;64(4):531-7.
  • Moreau R, Lebrec D. The use of vasoconstrictors in patients with cir-rhosis: type 1 HRS and beyond. Hepatol. 2006;43(3):385-94.
  • Ginès P, Guevara M. Therapy with vasoconstrictor drugs in cirrhosis: The time has arrived. Hepatol. 2007;46(6):1685-7.
  • Runyon BA; AASLD. Introduction to the revised American As-sociation for the Study of Liver Diseases Practice Guideline management of adult patients with ascites due to cirrhosis 2012. Hepa-tol. 2013;57(4):1651-3.
  • Salerno F, Guevara M, Bernardi M, Moreau R, Wong F, Angeli P, et al. Refractory ascites: pathogenesis, definition and therapy of a severe complication in patients with cirrhosis. Liver Int. 2010;30(7):937-47.
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