Review of literature: Renal abnormalities in liver disease

Abstract

Renal failure is a common complication of liver cirrhosis and of utmost clinical and prognostic relevance. Patients with cirrhosis are more prone to developing acute kidney injury than the non-cirrhotic population. The differential diagnosis of renal dysfunction in advanced liver disease includes pre-renal failure, intrinsic renal failure and hepatorenal syndrome. Hepatorenal syndrome is a complication of advanced cirrhosis characterized by an abrupt deterioration in renal function. In cirrhosis with ascites, hepatorenal syndrome is a specific prerenal dysfunction. It is unresponsive to fluid volume expansion and is associated with an extremely poor prognosis. An accurate assessment of renal function is recommended in all patients with cirrhosis. Liver transplantation remains the definitive treatment for hepatorenal syndrome, but new treatment strategies can be utilized as a bridge to transplantation. This review provides an update on our present understanding of the underlying pathophysiological mechanisms involved, diagnostic criteria, different treatment approaches and strategies to prevent Hepatorenal Syndrome.