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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 ... #Syndrome #HRS ... #nephrology
Hepatorenal Syndrome (HRS) - Diagnostic Criteria
HRS-AKI (Acute: previously known as HRS Type 1)
 • ↑ Creatinine
Hepatorenal Syndrome ... Criteria HRS-AKI ... nephrotoxics (e.g. diuretics ... renal ultrasound HRS-NAKI ... Type 2) • HRS-AKD
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... especially thiazide diuretics ... heart failure • Cirrhosis ... • Reduced GFR, AKI ... #Hyponatremia #Nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... especially thiazide diuretics ... heart failure • Cirrhosis ... • Reduced GFR, AKI ... #Hyponatremia #Nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Hypovolemia, UNa > 20: 
 • Renal losses, Diuretic excess,
Causes of Hyponatremia ... Differential Diagnosis Algorithm ... Renal losses, Diuretic ... , Cirrhosis, Cardiac ... #Causes #nephrology
Acute Kidney Injury - AKI Workup Algorithm and Differential Diagnosis
Baseline Investigations: full blood count with differential,
Workup Algorithm ... osmolarity If cause ... #Workup #Algorithm ... Differential #Diagnosis #nephrology ... #causes
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
normal volume-based algorithm ... , Post-AKI diuresis ... Heart failure, Cirrhosis ... , Nephrotic syndrome ... table #sodium #nephrology
Diuretics and Agents Regulating Renal Excretion

Carbonic Anhydrase Inhibitors (Acetazolamide, Dichlorphenamide)
 • Glaucoma
 • Epilepsy
 • Altitude
disequilibrium syndrome ... failure, liver cirrhosis ... and nephrotic syndrome ... Kidney stones caused ... #Nephrology #Pharmacology
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
Causes of Acute Kidney Injury (AKI) - Differential Diagnosis Algorithm
Acute Kidney Injury (AKI) - Acute increase
Causes of Acute ... Differential Diagnosis Algorithm ... • Hepatorenal syndromes ... Ethylene glycol) TTP/HUS ... #KidneyInjury #Nephrology