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Renal diseases and the liver.
1Department of Medicine, Toronto General Hospital, University of Toronto, 9th floor, North Wing, Room 983, 200 Elizabeth Street, Toronto M5G 2C4, Ontario, Canada. florence.wong@utoronto.ca
Clinics in Liver Disease
|November 30, 2010
Summary
Many liver and kidney diseases often coexist due to systemic conditions. Managing these dual conditions, especially viral hepatitis and cirrhosis, presents challenges, particularly before and after kidney transplantation.
Area of Science:
- Nephrology
- Hepatology
- Internal Medicine
Background:
- Systemic conditions frequently cause coexisting liver and kidney diseases.
- Viral hepatitis is common in chronic renal disease patients, often acquired during dialysis.
- Renal tubular dysfunction is frequently observed with cholestasis.
Purpose of the Study:
- To review the complex relationship between liver and kidney diseases.
- To highlight management challenges and treatment strategies for patients with concurrent liver and renal conditions.
- To discuss rare liver complications of renal disease and their management.
Main Methods:
- Literature review of studies on liver and kidney disease interactions.
- Analysis of clinical presentations and management of coexisting conditions.
- Examination of specific cases like nephrogenic ascites and hepatic dysfunction.
Main Results:
- Liver and kidney diseases frequently coexist, complicating patient management.
- Viral hepatitis requires treatment before renal transplantation.
- Nephrogenic ascites and hepatic dysfunction are uncommon but significant liver complications of renal disease.
- Combined liver and kidney transplantation is indicated for end-stage renal disease with advanced cirrhosis.
Conclusions:
- The interplay between liver and kidney diseases necessitates careful management strategies.
- Timely treatment of viral hepatitis and appropriate consideration of cirrhosis are crucial for renal transplant candidates.
- Rare renal-related liver conditions require specific interventions, including tumor removal or transplantation.
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