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A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
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Kidney Injury in Liver Disease
Kevin R Regner1, Kai Singbartl2
1Division of Nephrology, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA.
Critical Care Clinics
|June 25, 2016
Summary
Acute kidney injury (AKI) is common in liver disease patients, increasing mortality. Identifying suitable candidates for simultaneous liver-kidney transplantation (SLK) for prolonged AKI remains a critical, debated issue.
Area of Science:
- Nephrology
- Hepatology
- Transplantation
Background:
- Acute kidney injury (AKI) is a frequent complication in liver disease patients, significantly raising morbidity and mortality rates.
- Hepatorenal syndrome, a major cause of AKI in decompensated cirrhosis, stems from hemodynamic disturbances.
- Kidney function assessment, crucial for liver transplant eligibility (Model for End-stage Liver Disease score), is impacted by AKI.
Purpose of the Study:
- To review the challenges and considerations in managing acute kidney injury (AKI) in patients with liver disease.
- To discuss the role of continuous renal replacement therapy (CRRT) in critically ill liver failure patients with AKI.
- To explore the controversial aspects of identifying appropriate candidates for simultaneous liver-kidney transplantation (SLK).
Main Methods:
- Literature review of studies on AKI in liver disease.
- Analysis of hemodynamic alterations in hepatorenal syndrome.
- Examination of criteria for liver transplant and SLK candidacy.
Main Results:
- AKI significantly worsens outcomes for patients with liver disease.
- Hepatorenal syndrome is a key driver of AKI in cirrhosis, linked to hemodynamic changes.
- Continuous renal replacement therapy is a supportive measure for severe AKI in liver failure.
- Simultaneous liver-kidney transplantation is an option for prolonged AKI but candidate selection is debated.
Conclusions:
- AKI is a critical determinant of survival in liver disease.
- Management strategies for AKI in liver disease range from hemodynamic support to renal replacement therapy.
- Careful selection criteria are essential for simultaneous liver-kidney transplantation in patients with combined liver and kidney failure.
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