Publication Date
7-1-2024
Journal
Transplantation
DOI
10.1097/TP.0000000000004851
PMID
38192019
PMCID
PMC11188627
PubMedCentral® Posted Date
1-9-2024
PubMedCentral® Full Text Version
Post-Print
Published Open-Access
yes
Keywords
Humans, Liver Transplantation, End Stage Liver Disease, Hepatorenal Syndrome, Glomerular Filtration Rate, Risk Factors, Acute Kidney Injury, Kidney, Portasystemic Shunt, Transjugular Intrahepatic, Treatment Outcome, Renal Replacement Therapy
Abstract
Patients with decompensated end-stage liver disease (ESLD) are at increased risk for mortality, and only liver transplantation (LT) offers meaningful hope for survival. These patients are at risk for kidney dysfunction through the continuum of care for ESLD including LT. We discuss the role of accurate estimation and measurement of baseline glomerular filtration rate in assessment of kidney dysfunction among those with ESLD. Optimizing kidney function is a vital goal in the management of these patients before LT. In this review, we summarize salient aspects of assessing and optimizing kidney function in this patient population. Precipitating factors and different causes of acute kidney injury are discussed, including hepatorenal syndrome. We further review treatment options for acute kidney injury including volume management. The role of vasopressor therapy, renal replacement therapy, and transjugular intrahepatic portosystemic shunting are discussed.
Graphical Abstract
Included in
Digestive System Diseases Commons, Gastroenterology Commons, Hepatology Commons, Medical Sciences Commons