Angeli, Paolo3; Sanyal, Arun4; Møller, Søren1; Alessandria, Carlo5; Gadano, Adrian6; Kim, Ray7; Sarin, Shiv K.8; Bernardi and on behalf of the International Club of Ascites, Mauro9
1 Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and research, Amager and Hvidovre Hospital, The Capital Region of Denmark2 Amager Hospital, Amager and Hvidovre Hospital, The Capital Region of Denmark3 Department of Medicine, Unit of Hepatic Emergencies and Liver Transplantation, University of Padova, Padova, Italy4 Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University School of Medicine, Richmond, Va, USA5 Division of Gastroenterology and Hepatology, San Giovanni Battista Hospital - University of Turin, Turin, Italy6 Liver Unit, Hospital Italiano de Buenos Aires-Argentina, Buenos Aires, Argentina7 Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN, USA8 Department of Hepatology, Institute of Liver and Biliary Sciences (ILBS), New Delhi, India9 Department of Clinical Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy
Advanced cirrhosis is often complicated by a multi organ failure syndrome which involves many different organs besides the liver. The high morbidity and mortality secondary to this clinical setting is often related to renal dysfunction, either alone or, more frequently, in combination with other organ dysfunction. A clear defintion of renal dysfunction, an accurate differential diagnostic process of its different phenotypes as well as of full understanding of its pathophysiological mechanisms are crucial to the development of strategies for the management of this complication. This article is based either on the more recent knowledge on renal dysfunction in advanced cirrhosis or current opinions among the members of the International Club of Ascites (ICA) on the management of this complication, obtained through a survey and discussed during the EASL-ICA Joint Meeting in Berlin in March 2011. It reviews critically our current knowledge and it outlines future perspectives, on the management of renal dysfunction in patients with cirrhosis.
Journal review article
Liver International : Official Journal of the International Association for the Study of the Liver, 2013, p. 16-23