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diagnosis hepatology management differential algorithm failure hepatitis indications medications nephrology aclf aih aki albumin autoimmune chemistry chronic dehydrogenase dili diuresis
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Acute-on-Chronic ... those with CLD (± cirrhosis ... months without treatment ... Circulation Failure Kidney ... Injury (DILI)
Indications for Albumin for Management of Cirrhosis • Large volume paracentesis (>5 liter) - 8g per
Management of Cirrhosis ... ascites removed • Acute ... kidney injury ( ... Indications #Management #Cirrhosis ... #treatment #hepatology
Clinical manifestations of acute liver failure Brain: Hepatic encephalopathy, Cerebral edema, Intracranial hypertension,
liver failure ... Seizures Kidney ... Subclinical myocardial injury ... lung injury, ... #Signs #Symptoms
Acute Liver Injury - Differential Diagnosis Algorithm Vascular Causes of Acute Liver Injury: • Hepatic vein:
Acute Liver Injury ... Liver Injury: ... Liver Injury: ... Liver Injury: ... hepatitis: < 1 • Cirrhosis
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
injury < 26 weeks ... hepatitis: < 1 • Cirrhosis ... cardiac muscle, RBC, Kidney ... Cardiac muscle, Kidneys ... trimester placenta, kidneys
Diuretics and Agents Regulating Renal Excretion Carbonic Anhydrase Inhibitors (Acetazolamide, Dichlorphenamide) • Glaucoma • Epilepsy • Altitude
Torsemide) • Acute ... cirrhosis, chronic ... cirrhosis, and ... hyperaldosteronism • Acute ... Tolvaptan) • Treatment
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm DILI suspicion Features toxic aetiology: Skin involvement, Kidney injury,
Injury (DILI) - ... Skin involvement, Kidney ... injury, Previous ... non-essential drug/HDS treatments ... dechallenge • Acute
Hepatitis B - Treatment Indications Treatment not indicated: • Immune tolerant state - HBe-Ag detectable, high HBV
Family history of cirrhosis ... or fibrosis • Cirrhosis ... injury (INR > 2 ... > 3 mg/dL) or acute ... liver failure
Acute Kidney Injury (AKI) - Management Principles Prerenal - Correct hemodynamic derangements: • If low preload →
Acute Kidney Injury ... Treat underlying liver ... → No specific treatment ... #Kidney #Injury ... #treatment #management
Metformin Associated Lactic Acidosis (MALA) Pathophysiology of MALA - Metformin interferes with the activity of the
cycle found in the liver ... gastrointestinal distress and acute ... kidney injury are ... also includes symptoms
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