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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 ... #Hepatorenal #Syndrome ... #HRS #Management ... #Algorithm #nephrology
Hepatorenal Syndrome (HRS) - Diagnostic Criteria
HRS-AKI (Acute: previously known as HRS Type 1)
 • ↑ Creatinine
Hepatorenal Syndrome ... (Acute: previously ... in 3 months • Cirrhosis ... (Non-Acute: previously ... #Hepatorenal #Syndrome
Indications for Albumin for Management of Cirrhosis
 • Large volume paracentesis (>5 liter) - 8g per
of Cirrhosis ... ascites removed • Acute ... kidney injury ( ... antibiotics • Hepatorenal ... syndrome - 1g/
Acute Kidney Injury - Classification
Prerenal:
 • Dehydration
 • Heart failure (a.k.a. cardiorenal syndrome)
 • Liver failure
Acute Kidney Injury ... failure (a.k.a. hepatorenal ... syndrome) Intrarenal ... vasculitis - TTP/HUS ... #Kidney #Injury
Causes of Acute Kidney Injury (AKI) - Differential Diagnosis Algorithm
Acute Kidney Injury (AKI) - Acute increase
Kidney Injury (AKI ... Kidney Injury ( ... Hypoperfusion • Hepatorenal ... syndromes • Drugs ... Ethylene glycol) TTP/HUS
Acute Kidney Injury - AKI Workup Algorithm and Differential Diagnosis
Baseline Investigations: full blood count with differential,
Acute Kidney Injury ... clinical context and signs ... pressure • TTP / HUS ... • Cardio-renal syndrome ... #Kidney #Injury
Diuretics and Agents Regulating Renal Excretion

Carbonic Anhydrase Inhibitors (Acetazolamide, Dichlorphenamide)
 • Glaucoma
 • Epilepsy
 • Altitude
disequilibrium syndrome ... irrigation • Management ... Torsemide) • Acute ... hyperaldosteronism • Acute ... Excretion #Diuresis #Nephrology
Hepatorenal Syndrome (HRS)

Definition:
• Functional, potentially reversible kidney impairment.
• Occurs in advanced liver disease: cirrhosis, severe alcoholic
Hepatorenal Syndrome ... liver disease: cirrhosis ... hepatitis, or acute ... #HRS #Hepatorenal ... #Syndrome #Hepatology