Renal failure and cirrhosis: A systematic review of mortality and prognosis

KDIGO (Kidney Disease: Improving Global Outcomes) criteria as a predictor of hospital mortality in cirrhotic patients

“…Fede et al (24) investigated the effect of renal failure on mortality rates in cirrhotic patients. In this study, a systematic review of 74 articles showed that renal insufficiency increased mortality rates in cirrhotic patients seven-fold.…”

Keeping high model for end‐stage liver disease score liver transplantation candidates alive

“…In a recent systematic review, mortality increased 7-fold in patients with cirrhosis with the onset of renal failure with most deaths occurring in the first month. 32 Renal failure complicates the course of approximately 20% of hospitalized patients with cirrhosis. 33 An increase in sCr 1.5 mg/dL had been the conventional threshold to diagnose AKI in patients with cirrhosis.…”

Perioperative Risk Assessment and Management of Cirrhotic Patients

“…Acute renal failure occurs in 20% of hospitalized cirrhotics, and is associated a poor prognosis and high mortality rate [64]. Death increases 7-fold in LC with renal dysfunction; 50% die within one month of the onset [65].…”

“…HRS Mechanism: [64][65][66][67][68][69] PHTN → splanchnic arterial vasodilation → ↑ portal venous flow/PHTN Sodium retention with water and ascites develop → ↑ endogenous natriuretic hormones ↑ sodium retention → ↑ plasma renin activity and NE levels Extra-splanchnic organ vasoconstriction compensates splanchnic arterial vasodilation → ↓renal/cerebral/muscular flow ↑ plasma renin and NE, ↓ renal perfusion and GFR → ↑ADH and ↓ free water clearance HRS Prevention: [48,72,166] During 48,70,71,74] Avoid excess fluid administration…”