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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
Hepatorenal Syndrome (HRS) - Diagnostic Criteria
HRS-AKI (Acute: previously known as HRS Type 1)
 • ↑ Creatinine
Hepatorenal Syndrome ... Criteria HRS-AKI ... renal ultrasound HRS-NAKI ... Type 2) • HRS-AKD ... - No other cause
HepatoRenal Syndrome - Pathophysiology

Dr. Edgar V. Lerma @edgarvlermamd - Nephrology Secrets https://amzn.to/34t5DgJ

#HRS #HepatoRenal #Syndrome #Pathophysiology #Diagnosis
HepatoRenal Syndrome ... edgarvlermamd - Nephrology ... amzn.to/34t5DgJ #HRS ... #HepatoRenal #Syndrome ... #AKI
Acute Kidney Injury (AKI) - Differential Diagnosis Framework
Pre-Renal:
 • Hypovolemia, Cardiorenal, Distributive Shock, HRS, Hypercalcemia, Renal
Kidney Injury (AKI ... Distributive Shock, HRS ... Abdominal Compartment Syndrome ... Differential #Diagnosis #nephrology ... #causes #algorithm
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 ... CONSIDER INTRINSIC CAUSES ... workup #diagnosis #nephrology
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 ... vasculitis - TTP/HUS ... tubular necrosis (causes ... Classification #diagnosis #nephrology
Causes of Acute Kidney Injury (AKI) - Differential Diagnosis Algorithm
Acute Kidney Injury (AKI) - Acute increase
Causes of Acute ... Kidney Injury (AKI ... • Hepatorenal syndromes ... Ethylene glycol) TTP/HUS ... #KidneyInjury #Nephrology
Acute Kidney Injury - AKI Workup Algorithm and Differential Diagnosis
Baseline Investigations: full blood count with differential,
osmolarity If cause ... pressure • TTP / HUS ... • Cardio-renal syndrome ... Differential #Diagnosis #nephrology ... #causes
Nephritic vs Nephrotic Syndrome

Step 1: If the patient has hematuria and/or proteinuria, think about nephrotic/nephritic syndromes.
Step
Nephritic vs Nephrotic Syndrome ... If the patient has ... nephrotic/nephritic syndromes ... hematuria (RBC casts ... Comparison #Algorithm #Nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Diagnosis Algorithm Syndrome ... • Nephrotic syndrome ... • Reduced GFR, AKI ... #Hyponatremia #Nephrology