Acute kidney injury and point-of-care ultrasound in liver cirrhosis: redefining hepatorenal syndrome

Acute kidney injury (AKI) in patients with cirrhosis is a diagnostic challenge due to multiple and sometimes overlapping possible etiologies. Many times, diagnosis cannot be made based on case history, physical examination or laboratory data, especially when the nephrologist is faced with AKI with a...

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Bibliographic Details
Published in:Clinical kidney journal 2024-05, Vol.17 (5), p.sfae112-sfae112
Main Authors: Banegas-Deras, Eduardo Josué, Mazón-Ruiz, Jaime, Romero-González, Gregorio, Ruiz-Cobo, Juan Carlos, Sanz-García, Clara, Serrano-Soto, Mara, Sánchez, Emilio, Argaiz, Eduardo R
Format: Article
Language:English
Subjects:
Albumin
CKJ Review
Diuretics
Liver cirrhosis
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Summary:Acute kidney injury (AKI) in patients with cirrhosis is a diagnostic challenge due to multiple and sometimes overlapping possible etiologies. Many times, diagnosis cannot be made based on case history, physical examination or laboratory data, especially when the nephrologist is faced with AKI with a hemodynamic basis, such as hepatorenal syndrome. In addition, the guidelines still include generalized recommendations regarding withdrawal of diuretics and plasma volume expansion with albumin for 48 h, which may be ineffective and counterproductive and may have iatrogenic effects, such as fluid overload and acute cardiogenic pulmonary edema. For this reason, the use of new tools, such as hemodynamic point-of-care ultrasound (PoCUS), allows us to phenotype volume status more accurately and ultimately guide medical treatment in a noninvasive, rapid and individualized manner.
ISSN:2048-8505
2048-8513
DOI:10.1093/ckj/sfae112