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AKI in Cirrhosis - Hepatorenal Syndrome Management Algorithm

DOI: 10.1136/bmj.m2687

#AKI #Cirrhosis #Hepatorenal #Syndrome #HRS #Management #Algorithm #nephrology
AKI in Cirrhosis ... - Hepatorenal Syndrome ... Management Algorithm ... #HRS #Management ... #Algorithm #nephrology
Causes of Acute Kidney Injury (AKI) - Differential Diagnosis Algorithm
Acute Kidney Injury (AKI) - Acute increase
• Hepatorenal syndromes ... polyangiitis /microscopic ... hydronephrosis on UIS) • Benign ... #KidneyInjury #Nephrology ... Diagnosis #Algorithm #Causes
Acute Kidney Injury - AKI Workup Algorithm and Differential Diagnosis
Baseline Investigations: full blood count with differential,
dipstick, urine microscopy ... osmolarity If cause ... • Cardio-renal syndrome ... Differential #Diagnosis #nephrology ... #causes
Acute Kidney Injury - Classification
Prerenal:
 • Dehydration
 • Heart failure (a.k.a. cardiorenal syndrome)
 • Liver failure
a.k.a. cardiorenal syndrome ... a.k.a. hepatorenal syndrome ... tubular necrosis (causes ... Medications • Benign ... Classification #diagnosis #nephrology
Simplified Approach to Acute Kidney Injury (AKI)
1) IS THIS AN EMERGENCY? 
Is there a dialysis indication
Kidney Injury (AKI ... require urgent nephrology ... PROBLEM ~80% of AKI ... Assess UA w/ microscopy ... workup #diagnosis #nephrology
Algorithmic Approach to Acute Interstitial Nephritis
When to suspect AIN? (not sensitive)
 • AKI, AKD, rapidly progressive
sensitive) • AKI ... , AKD, rapidly progressive ... sterile pyuria, WBC casts ... eosinophiluria, microscopic ... AIN #Algorithm #nephrology
Guide to Acute Kidney Injury (AKI)

What to ask/look for: 
 - HPI, PMH, full ROS
Kidney Injury (AKI ... - Urinalysis/microscopy ... rhabdo/TLS) Causes ... #Nephrology #Diagnosis ... #Algorithm #Causes
Common causes of Acute Kidney Injury AKI - Differential Diagnosis
HEMODYNAMIC
 • Cardiac failure: Impaired forward flow,
Common causes of ... Kidney Injury AKI ... inhibitors, hepatorenal syndrome ... Prostatic enlargement (benign ... Differential #Diagnosis #nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Diagnosis Algorithm Syndrome ... Pain/Post-op • Neurologic ... • Reduced GFR, AKI ... #Hyponatremia #Nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Diagnosis Algorithm Syndrome ... Pain/Post-op • Neurologic ... • Reduced GFR, AKI ... #Hyponatremia #Nephrology