{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:13:21Z","timestamp":1791504801450,"version":"4.3.4"},"reference-count":60,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":4595,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2003,2]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>In patients with cirrhosis, acute renal failure is mainly due to prerenal failure (caused by renal hypoperfusion) and tubular necrosis. The main causes of prerenal failure are \u201ctrue hypovolemia\u201d (induced by hemorrhage or gastrointestinal or renal fluid losses), sepsis, or type 1 hepatorenal syndrome (HRS). The frequency of prerenal failure due to the administration of nonsteroidal anti-inflammatory drugs or intravascular radiocontrast agents is unknown. Prerenal failure is rapidly reversible after restoration of renal blood flow. Treatment is directed to the cause of hypoperfusion, and fluid replacement is used to treat most cases of \u201cnon-HRS\u201d prerenal failure. In patients with type 1 HRS with very low short-term survival rate, liver transplantation is the ideal treatment. Systemic vasoconstrictor therapy (with terlipressin, noradrenaline, or midodrine [combined with octreotide]) may improve renal function in patients with type 1 HRS waiting for liver transplantation. MARS (for molecular adsorbent recirculating system) and the transjugular intrahepatic portosystemic shunt may also improve renal function in these patients. In patients with cirrhosis, acute tubular necrosis is mainly due to an ischemic insult to the renal tubules. The most common condition leading to ischemic acute tubular necrosis is severe and sustained prerenal failure. Little is known about the natural course and treatment (<jats:italic toggle=\"yes\">i.e.<\/jats:italic>, renal replacement therapy) of cirrhosis-associated acute tubular necrosis.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1053\/jhep.2003.50084","type":"journal-article","created":{"date-parts":[[2003,2,5]],"date-time":"2003-02-05T02:43:33Z","timestamp":1044413013000},"page":"233-243","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":194,"title":["Acute renal failure in patients with cirrhosis: Perspectives in the age of MELD"],"prefix":"10.1097","volume":"37","author":[{"given":"Richard","family":"Moreau","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didier","family":"Lebrec","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"10.1053\/jhep.2003.50084-BIB1","doi-asserted-by":"crossref","first-page":"601","DOI":"10.7326\/0003-4819-123-8-199510150-00007","volume":"123","author":"Abuelo","year":"1995","journal-title":"Ann Intern"},{"key":"10.1053\/jhep.2003.50084-BIB2","doi-asserted-by":"crossref","first-page":"1533","DOI":"10.1016\/S0140-6736(95)92057-9","volume":"346","author":"Brady","year":"1998","journal-title":"Lancet"},{"key":"10.1053\/jhep.2003.50084-BIB3","doi-asserted-by":"crossref","first-page":"1448","DOI":"10.1056\/NEJM199605303342207","volume":"334","author":"Thadhani","year":"1996","journal-title":"N Engl J Med"},{"key":"10.1053\/jhep.2003.50084-BIB4","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1002\/hep.510230122","volume":"23","author":"Arroyo","year":"1996","journal-title":"Hepatology"},{"key":"10.1053\/jhep.2003.50084-BIB5","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1053\/jhep.2001.27830","volume":"34","author":"Cardenas","year":"2001","journal-title":"Hepatology"},{"key":"10.1053\/jhep.2003.50084-BIB6","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/0016-5085(82)90129-9","volume":"82","author":"Cabrera","year":"1982","journal-title":"Gastroenterology"},{"key":"10.1053\/jhep.2003.50084-BIB7","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1055\/s-2007-1007201","volume":"17","author":"Bataller","year":"1997","journal-title":"Semin Liv Dis"},{"key":"10.1053\/jhep.2003.50084-BIB8","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1042\/cs0920433","volume":"92","author":"Moore","year":"1997","journal-title":"Clin Sci"},{"key":"10.1053\/jhep.2003.50084-BIB9","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1053\/jhep.2001.29200","volume":"34","author":"Wong","year":"2001","journal-title":"Hepatology"},{"key":"10.1053\/jhep.2003.50084-BIB10","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1046\/j.1440-1746.2002.02778.x","volume":"17","author":"Moreau","year":"2002","journal-title":"J Gastroenterol Hepatol"},{"key":"10.1053\/jhep.2003.50084-BIB11","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1056\/NEJM199908053410603","volume":"341","author":"Sort","year":"1999","journal-title":"N Engl J Med"},{"key":"10.1053\/jhep.2003.50084-BIB12","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1136\/gut.50.1.90","volume":"50","author":"Moreau","year":"2002","journal-title":"Gut"},{"key":"10.1053\/jhep.2003.50084-BIB13","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1053\/gast.2002.32364","volume":"122","author":"Moreau","year":"2002","journal-title":"Gastroenterology"},{"key":"10.1053\/jhep.2003.50084-BIB14","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1159\/000187513","volume":"65","author":"Moreau","year":"1993","journal-title":"Nephron"},{"key":"10.1053\/jhep.2003.50084-BIB15","first-page":"168","volume-title":"Portal hypertension III. 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