INGRESAR
CREAR CUENTA
Artículos
Patofisiología, diagnóstico y tratamiento | 20 OCT 20

Síndrome hepatorrenal

Novedosas e importantes modificaciones en la definición, criterios diagnóstico y tratamiento del síndrome hepatorrenal
5
Autor/a: Douglas A Simonetto, Pere Gines,Patrick S Kamath BMJ 2020;370:m2687
INDICE:  1. Texto principal | 2. Texto principal
Texto principal
  1. Fagundes C, Barreto R, Guevara M, et al. A modified acute kidney injury classification for diagnosis and risk stratification of impairment of kidney function in cirrhosis. J Hepatol 2013;59:474-81. doi:10.1016/j.jhep.2013.04.036
  2.  Wu CC, Yeung LK, Tsai WS, et al. Incidence and factors predictive of acute renal failure in patients with advanced liver cirrhosis. Clin Nephrol 2006;65:28-33. doi:10.5414/CNP65028 
  3. Piano S, Rosi S, Maresio G, et al. Evaluation of the Acute Kidney Injury Network criteria in hospitalized patients with cirrhosis and ascites. J Hepatol 2013;59:482-9. doi:10.1016/j.jhep.2013.03.039 
  4. Sujan R, Cruz-Lemini M, Altamirano J, et al. A Validated Score Predicts Acute Kidney Injury and Survival in Patients With Alcoholic Hepatitis. Liver Transpl 2018;24:1655-64. doi:10.1002/lt.25328 
  5. Sherman DS, Fish DN, Teitelbaum I. Assessing renal function in cirrhotic patients: problems and pitfalls. Am J Kidney Dis 2003;41:269-78. doi:10.1053/ajkd.2003.50035 
  6. 6  Caregaro L, Menon F, Angeli P, et al. Limitations of serum creatinine level and creatinine clearance as filtration markers in cirrhosis. Arch Intern Med 1994;154:201-5. doi:10.1001/archinte.1994.00420020117013 
  7. Mindikoglu AL, Dowling TC, Weir MR, Seliger SL, Christenson RH, Magder LS. Performance of chronic kidney disease epidemiology collaboration creatinine-cystatin C equation for estimating kidney function in cirrhosis. Hepatology 2014;59:1532-42. doi:10.1002/ hep.26556 
  8. Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P, Acute Dialysis Quality Initiative workgroup. Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care 2004;8:R204-12. doi:10.1186/cc2872 
  9. Mehta RL, Kellum JA, Shah SV, et al, Acute Kidney Injury Network. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care 2007;11:R31. doi:10.1186/cc5713
  10. Lassnigg A, Schmidlin D, Mouhieddine M, et al. Minimal changes of serum creatinine predict prognosis in patients after cardiothoracic surgery: a prospective cohort study. J Am Soc Nephrol 2004;15:1597-605. doi:10.1097/01. ASN.0000130340.93930.DD 
  11. 1  Chertow GM, Burdick E, Honour M, Bonventre JV, Bates DW. Acute kidney injury, mortality, length of stay, and costs in hospitalized patients. J Am Soc Nephrol 2005;16:3365-70. doi:10.1681/ ASN.2004090740
  12. Summary of Recommendation Statements. Kidney Int Suppl (2011) 2012;2:8-12. doi:10.1038/kisup.2012.7 
  13. Arroyo V, Ginès P, Gerbes AL, et al. Definition and diagnostic criteria of refractory ascites and hepatorenal syndrome in cirrhosis. International Ascites Club. Hepatology 1996;23:164-76. doi:10.1002/hep.510230122 
  14. 14  Belcher JM, Garcia-Tsao G, Sanyal AJ, et al, TRIBE-AKI Consortium. Association of AKI with mortality and complications in hospitalized patients with cirrhosis. Hepatology 2013;57:753-62. doi:10.1002/ hep.25735 
  15. Tsien CD, Rabie R, Wong F. Acute kidney injury in decompensated cirrhosis. Gut 2013;62:131-7. doi:10.1136/gutjnl-2011-301255 
  16. de Carvalho JR, Villela-Nogueira CA, Luiz RR, et al. Acute kidney injury network criteria as a predictor of hospital mortality in cirrhotic patients with ascites. J Clin Gastroenterol 2012;46:e21-6. doi:10.1097/MCG.0b013e31822e8e12
  17. Wong F, O’Leary JG, Reddy KR, et al, North American Consortium for Study of End-Stage Liver Disease. New consensus definition of acute kidney injury accurately predicts 30-day mortality in patients with cirrhosis and infection. Gastroenterology 2013;145:1280-8.e1. doi:10.1053/j.gastro.2013.08.051 
  18. Altamirano J, Fagundes C, Dominguez M, et al. Acute kidney injury is an early predictor of mortality for patients with alcoholic hepatitis. Clin Gastroenterol Hepatol 2012;10:65-71.e3. doi:10.1016/j. cgh.2011.09.011 
  19. Angeli P, Gines P, Wong F, et al, International Club of Ascites. Diagnosis and management of acute kidney injury in patients with cirrhosis: revised consensus recommendations of the International Club of Ascites. Gut 2015;64:531-7. doi:10.1136/ gutjnl-2014-308874
  20. Amathieu R, Al-Khafaji A, Sileanu FE, et al. Significance of oliguria in critically ill patients with chronic liver disease. Hepatology 2017;66:1592-600. doi:10.1002/hep.29303 
  21. Angeli P, Garcia-Tsao G, Nadim MK, Parikh CR. News in pathophysiology, definition and classification of hepatorenal syndrome: A step beyond the International Club of Ascites (ICA) consensus document. J Hepatol 2019;71:811-22. doi:10.1016/j. jhep.2019.07.002 
  22. Boyer TD, Sanyal AJ, Garcia-Tsao G, et al, Terlipressin Study Group. Predictors of response to terlipressin plus albumin in hepatorenal syndrome (HRS) type 1: relationship of serum creatinine to hemodynamics. J Hepatol 2011;55:315-21. doi:10.1016/j. jhep.2010.11.020 
  23. Martín-Llahí M, Pépin MN, Guevara M, et al, TAHRS Investigators. Terlipressin and albumin vs albumin in patients with cirrhosis and  hepatorenal syndrome: a randomized study. Gastroenterology 2008;134:1352-9. doi:10.1053/j. gastro.2008.02.024 
  24. National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 2002;39(Suppl 1):S1-266.
  25. Schrier RW, Arroyo V, Bernardi M, Epstein M, Henriksen JH, Rodés J. Peripheral arterial vasodilation hypothesis: a proposal for the initiation of renal sodium and water retention in cirrhosis. Hepatology 1988;8:1151-7. doi:10.1002/hep.1840080532 
  26. Ruiz-del-Arbol L, Monescillo A, Arocena C, et al. Circulatory function and hepatorenal syndrome in cirrhosis. Hepatology 2005;42:439- 47. doi:10.1002/hep.20766 
  27. Varga ZV, Erdelyi K, Paloczi J, et al. Disruption of Renal Arginine Metabolism Promotes Kidney Injury in Hepatorenal Syndrome in Mice. Hepatology 2018;68:1519-33. doi:10.1002/hep.29915 
  28. Thabut D, Massard J, Gangloff A, et al. Model for end-stage liver disease score and systemic inflammatory response are major prognostic factors in patients with cirrhosis and acute functional renal failure. Hepatology 2007;46:1872-82. doi:10.1002/ hep.21920  }
  29. Solé C, Solà E, Huelin P, et al. Characterization of inflammatory response in hepatorenal syndrome: Relationship with kidney outcome and survival. Liver Int 2019;39:1246-55. doi:10.1111/ liv.14037 
  30. Shah N, Mohamed FE, Jover-Cobos M, et al. Increased renal expression and urinary excretion of TLR4 in acute kidney injury associated with cirrhosis. Liver Int 2013;33:398-409. doi:10.1111/ liv.12047 
  31. Shah N, Dhar D, El Zahraa Mohammed F, et al. Prevention of acute kidney injury in a rodent model of cirrhosis following selective gut decontamination is associated with reduced renal TLR4 expression. J Hepatol 2012;56:1047-53. doi:10.1016/j.jhep.2011.11.024 
  32. Rivolta R, Maggi A, Cazzaniga M, et al. Reduction of renal cortical blood flow assessed by Doppler in cirrhotic patients with refractory ascites. Hepatology 1998;28:1235-40. doi:10.1002/ hep.510280510 
  33. Mindikoglu AL, Dowling TC, Wong-You-Cheong JJ, et al. A pilot study to evaluate renal hemodynamics in cirrhosis by simultaneous glomerular filtration rate, renal plasma flow, renal resistive indices and biomarkers measurements. Am J Nephrol 2014;39:543-52. doi:10.1159/000363584 
  34. Jang HR, Rabb H. Immune cells in experimental acute kidney injury. Nat Rev Nephrol 2015;11:88-101. doi:10.1038/nrneph.2014.180 
  35. Jang JY, Kim TY, Sohn JH, et al. Relative adrenal insufficiency in chronic liver disease: its prevalence and effects on long-term mortality. Aliment Pharmacol Ther 2014;40:819-26. doi:10.1111/apt.12891 
  36. Singh RR, Walia R, Sachdeva N, Bhalla A, Singh A, Singh V. Relative adrenal insufficiency in cirrhotic patients with ascites (hepatoadrenal syndrome). Dig Liver Dis 2018;50:1232-7. doi:10.1016/j. dld.2018.05.011  }
  37. Piano S, Favaretto E, Tonon M, et al. Including Relative Adrenal Insufficiency in Definition and Classification of Acute-on-Chronic Liver Failure. Clin Gastroenterol Hepatol 2020;18:1188-1196.e3. doi:10.1016/j.cgh.2019.09.035 
  38. Acevedo J, Fernández J, Prado V, et al. Relative adrenal insufficiency in decompensated cirrhosis: Relationship to shortterm risk of severe sepsis, hepatorenal syndrome, and death. Hepatology 2013;58:1757-65. doi:10.1002/hep.26535 
  39. Tsai MH, Peng YS, Chen YC, et al. Adrenal insufficiency in patients with cirrhosis, severe sepsis and septic shock. Hepatology 2006;43:673- 81. doi:10.1002/hep.21101 
  40. Kim G, Huh JH, Lee KJ, Kim MY, Shim KY, Baik SK. Relative Adrenal Insufficiency in Patients with Cirrhosis: A Systematic Review and Meta-Analysis. Dig Dis Sci 2017;62:1067-79. doi:10.1007/s10620- 017-4471-8 
  41. Marik PE. Adrenal-exhaustion syndrome in patients with liver disease. Intensive Care Med 2006;32:275-80. doi:10.1007/s00134-005- 0005-5 
  42. 42  Bornstein SR. Predisposing factors for adrenal insufficiency. N Engl J Med 2009;360:2328-39. doi:10.1056/NEJMra0804635 
  43. Fernández J, Escorsell A, Zabalza M, et al. Adrenal insufficiency in patients with cirrhosis and septic shock: Effect of treatment with hydrocortisone on survival. Hepatology 2006;44:1288-95. doi:10.1002/hep.21352 
  44. Bräsen JH, Mederacke YS, Schmitz J, et al. Cholemic Nephropathy Causes Acute Kidney Injury and Is Accompanied by Loss of Aquaporin 2 in Collecting Ducts. Hepatology 2019;69:2107-19. doi:10.1002/ hep.30499 
  45. van Slambrouck CM, Salem F, Meehan SM, Chang A. Bile cast nephropathy is a common pathologic finding for kidney injury associated with severe liver dysfunction[published Online First: 2013/03/15]. Kidney Int 2013;84:192-7. doi:10.1038/ki.2013.78. 
  46. Nazar A, Pereira GH, Guevara M, et al. Predictors of response to therapy with terlipressin and albumin in patients with cirrhosis and type 1 hepatorenal syndrome. Hepatology 2010;51:219-26. doi:10.1002/hep.23283 
  47. Barreto R, Fagundes C, Guevara M, et al. Type-1 hepatorenal syndrome associated with infections in cirrhosis: natural history, outcome of kidney function, and survival. Hepatology 2014;59:1505-13. doi:10.1002/hep.26687 
  48. Krones E, Eller K, Pollheimer MJ, et al. NorUrsodeoxycholic acid ameliorates cholemic nephropathy in bile duct ligated mice. J Hepatol 2017;67:110-9. doi:10.1016/j.jhep.2017.02.019 
  49. Umgelter A, Reindl W, Wagner KS, et al. Effects of plasma expansion with albumin and paracentesis on haemodynamics and kidney function in critically ill cirrhotic patients with tense ascites and hepatorenal syndrome: a prospective uncontrolled trial. Crit Care 2008;12:R4. doi:10.1186/cc6765  }
  50. Velez JCQ, Petkovich B, Karakala N, Huggins JT. Point-of-Care Echocardiography Unveils Misclassification of Acute Kidney Injury as Hepatorenal Syndrome. Am J Nephrol 2019;50:204-11. doi:10.1159/000501299 
  51. Lang F, Tschernko E, Schulze E, et al. Hepatorenal reflex regulating kidney function. Hepatology 1991;14:590-4. doi:10.1002/ hep.1840140403 
  52. Ming Z, Smyth DD, Lautt WW. Decreases in portal flow trigger a hepatorenal reflex to inhibit renal sodium and water excretion in rats: role of adenosine. Hepatology 2002;35:167-75. doi:10.1053/ jhep.2002.30425 
  53. Garcia-Tsao G, Parikh CR, Viola A. Acute kidney injury in cirrhosis. Hepatology 2008;48:2064-77. doi:10.1002/hep.22605 
  54. Huelin P, Piano S, Solà E, et al. Validation of a Staging System for Acute Kidney Injury in Patients With Cirrhosis and Association With Acute-on-Chronic Liver Failure. Clin Gastroenterol Hepatol 2017;15:438-445.e5. doi:10.1016/j.cgh.2016.09.156 
  55. Dudley FJ, Kanel GC, Wood LJ, Reynolds TB. Hepatorenal syndrome without avid sodium retention. Hepatology 1986;6:248-51. doi:10.1002/hep.1840060216 
  56. Alsaad AA, Wadei HM. Fractional excretion of sodium in hepatorenal syndrome: Clinical and pathological correlation. World J Hepatol 2016;8:1497-501. doi:10.4254/wjh.v8.i34.1497 
  57. Carvounis CP, Nisar S, Guro-Razuman S. Significance of the fractional excretion of urea in the differential diagnosis of acute renal failure. Kidney Int 2002;62:2223-9. doi:10.1046/j.1523- 1755.2002.00683.x 
  58. Patidar KR, Kang L, Bajaj JS, Carl D, Sanyal AJ. Fractional excretion of urea: A simple tool for the differential diagnosis of acute kidney injury in cirrhosis. Hepatology 2018;68:224-33. doi:10.1002/ hep.29772 
  59. Francoz C, Nadim MK, Durand F. Kidney biomarkers in cirrhosis. J Hepatol 2016;65:809-24.doi:10.1016/j.jhep.2016.05.025 
  60. Allegretti AS, Solà E, Ginès P. Clinical application of kidney biomarkers in cirrhosis. Am J Kidney Dis 2020;S0272- 6386(20)30691-0.
  61. Fagundes C, Pépin MN, Guevara M, et al. Urinary neutrophil gelatinase-associated lipocalin as biomarker in the differential diagnosis of impairment of kidney function in cirrhosis. J Hepatol 2012;57:267-73. doi:10.1016/j.jhep.2012.03.015 
  62. Verna EC, Brown RS, Farrand E, et al. Urinary neutrophil gelatinaseassociated lipocalin predicts mortality and identifies acute kidney injury in cirrhosis. Dig Dis Sci 2012;57:2362-70. doi:10.1007/ s10620-012-2180-x 
  63. Belcher JM, Sanyal AJ, Peixoto AJ, et al, TRIBE-AKI Consortium. Kidney biomarkers and differential diagnosis of patients with cirrhosis and acute kidney injury. Hepatology 2014;60:622-32. doi:10.1002/ hep.26980 
  64. Huelin P, Solà E, Elia C, et al. Neutrophil Gelatinase-Associated Lipocalin for Assessment of Acute Kidney Injury in Cirrhosis: A Prospective Study. Hepatology 2019;70:319-33. doi:10.1002/ hep.30592 
  65. Hamdy HS, El-Ray A, Salaheldin M, et al. Urinary Neutrophil Gelatinase-Associated Lipocalin in Cirrhotic Patients with Acute Kidney Injury. Ann Hepatol 2018;17:624-30. doi:10.5604/01.3001.0012.0931 
  66. Barreto R, Elia C, Solà E, et al. Urinary neutrophil gelatinaseassociated lipocalin predicts kidney outcome and death in patients with cirrhosis and bacterial infections. J Hepatol 2014;61:35-42. doi:10.1016/j.jhep.2014.02.023 
  67. Ginès A, Escorsell A, Ginès P, et al. Incidence, predictive factors, and prognosis of the hepatorenal syndrome in cirrhosis with ascites. Gastroenterology 1993;105:229-36. doi:10.1016/0016- 5085(93)90031-7 
  68. Wong F, Jepsen P, Watson H, Vilstrup H. Un-precipitated acute kidney injury is uncommon among stable patients with cirrhosis and ascites. Liver Int 2018;38:1785-92. doi:10.1111/liv.13738 
  69. Follo A, Llovet JM, Navasa M, et al. Renal impairment after spontaneous bacterial peritonitis in cirrhosis: incidence, clinical course, predictive factors and prognosis. Hepatology 1994;20:1495- 501. doi:10.1002/hep.1840200619 
  70. 0  Terra C, Guevara M, Torre A, et al. Renal failure in patients with cirrhosis and sepsis unrelated to spontaneous bacterial peritonitis: value of MELD score. Gastroenterology 2005;129:1944-53. doi:10.1053/j.gastro.2005.09.024 
  71. Fasolato S, Angeli P, Dallagnese L, et al. Renal failure and bacterial infections in patients with cirrhosis: epidemiology and clinical features. Hepatology 2007;45:223-9. doi:10.1002/hep.21443
  72. Navasa M, Follo A, Filella X, et al. Tumor necrosis factor and interleukin-6 in spontaneous bacterial peritonitis in cirrhosis: relationship with the development of renal impairment and mortality. Hepatology 1998;27:1227-32. doi:10.1002/hep.510270507 
  73. Sort P, Navasa M, Arroyo V, et al. Effect of intravenous albumin on renal impairment and mortality in patients with cirrhosis and spontaneous bacterial peritonitis. N Engl J Med 1999;341:403-9. doi:10.1056/NEJM199908053410603 
  74. Salerno F, Navickis RJ, Wilkes MM. Albumin infusion improves outcomes of patients with spontaneous bacterial peritonitis: a meta-analysis of randomized trials. Clin Gastroenterol Hepatol 2013;11:123-30.e1. doi:10.1016/j.cgh.2012.11.007 
  75. Thévenot T, Bureau C, Oberti F, et al. Effect of albumin in cirrhotic patients with infection other than spontaneous bacterial peritonitis. A randomized trial. J Hepatol 2015;62:822-30. doi:10.1016/j. jhep.2014.11.017 
  76. Fernández J, Angeli P, Trebicka J, et al. Efficacy of Albumin Treatment for Patients with Cirrhosis and Infections Unrelated to Spontaneous Bacterial Peritonitis. Clin Gastroenterol Hepatol 2020;18:963-973. e14. doi:10.1016/j.cgh.2019.07.055 
  77. Guevara M, Terra C, Nazar A, et al. Albumin for bacterial infections other than spontaneous bacterial peritonitis in cirrhosis. A randomized, controlled study. J Hepatol 2012;57:759-65. doi:10.1016/j.jhep.2012.06.013 
  78. Leão GS, John Neto G, Jotz RF, Mattos AA, Mattos ÂZ. Albumin for cirrhotic patients with extraperitoneal infections: A meta-analysis. J Gastroenterol Hepatol 2019;34:2071-6. doi:10.1111/jgh.14791 
  79. Caraceni P, Riggio O, Angeli P, et al, ANSWER Study Investigators. Long-term albumin administration in decompensated cirrhosis (ANSWER): an open-label randomised trial. Lancet 2018;391:2417- 29. doi:10.1016/S0140-6736(18)30840-7 
  80. Solà E, Solé C, Simón-Talero M, et al. Midodrine and albumin for prevention of complications
« Página anterior
 

Comentarios

Para ver los comentarios de sus colegas o para expresar su opinión debe ingresar con su cuenta de IntraMed.

CONTENIDOS RELACIONADOS
Ascite, peritonite espontânea e síndrome hepatorrenal
Ascitis, peritonitis espontánea y síndrome hepatorrenal
» Centro de Atención IntraMed
AAIP RNBD
Términos y condiciones de uso | Política de privacidad | Todos los derechos reservados | Copyright 1997-2024