{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T05:29:48Z","timestamp":1766467788165,"version":"3.32.0"},"reference-count":55,"publisher":"Scientific Scholar","content-domain":{"domain":["indianjnephrol.org"],"crossmark-restriction":true},"short-container-title":["Indian J Nephrol"],"abstract":"<jats:sec>\n<jats:title>Introduction:<\/jats:title>\n<jats:p>Acute kidney injury (AKI) is a frequent complication of chronic liver disease (CLD) contributing to high morbidity and mortality worldwide. While liver transplantation (LT) has shown favorable outcomes, early identification and management of AKI is imperative for survival. This review aims to highlight the epidemiology, pathophysiology, management, and prognosis of AKI in CLD.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods:<\/jats:title>\n<jats:p>An extensive literature search was performed using PubMed, Medline, and Google Scholar to identify literature related to epidemiology, burden, clinical presentations, prognosis, and management of AKI in CLD.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results:<\/jats:title>\n<jats:p>The identified studies highlighted a wide range of prevalence of AKI in hospitalized patients with CLD. The etiology and pathophysiology are multifactorial and include prerenal AKI, acute tubular injury, sepsis, gastrointestinal bleeding, bacterial translocation from the gut, and hepatorenal syndrome (HRS). AKI is associated with a higher risk of morbidity and mortality and progression to chronic kidney disease following LT. Management of AKI in CLD varies based on the underlying etiology. While vasoconstrictors like terlipressin have shown great potential in the treatment of HRS-AKI and is widely used in Europe and United States, LT remains the definitive therapy of choice. In most cases, kidney replacement therapy serves as a bridge to liver transplant.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusion:<\/jats:title>\n<jats:p>AKI is a serious complication of CLD and early identification is essential. Diagnosis and management, particularly HRS is challenging and requires a high index of suspicion. More research is required to identify novel therapies to improve outcomes of AKI in patients with CLD.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/ijn_333_23","type":"journal-article","created":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T15:13:45Z","timestamp":1719242025000},"page":"21-28","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Acute Kidney Injury in Patients with Chronic Liver Disease: A Review"],"prefix":"10.25259","volume":"35","author":[{"given":"Hilary A.","family":"Elom","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Missouri School of Medicine, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yassmin","family":"Hegazy","sequence":"additional","affiliation":[{"name":"Department of Medicine, Columbia University, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edgar V","family":"Lerma","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Illinois at Chicago, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Hassanein","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Mississippi Medical Center, Jackson, United States,"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2024,6,24]]},"reference":[{"key":"10.25259\/ijn_333_23\/ref-1","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1016\/S2468-1253(19)30349-8","article-title":"The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017","volume":"5","author":"GBD 2017 Cirrhosis Collaborators","year":"2020","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"10.25259\/ijn_333_23\/ref-2","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1016\/j.jhep.2023.03.017","article-title":"Global burden of liver disease: 2023 Update","volume":"79","author":"Devarbhavi","year":"2023","journal-title":"J Hepatol"},{"key":"10.25259\/ijn_333_23\/ref-3","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15061687","article-title":"Causes of death among patients with hepatocellular carcinoma according to chronic liver disease etiology","volume":"15","author":"Yen","year":"2023","journal-title":"Cancers (Basel)"},{"key":"10.25259\/ijn_333_23\/ref-4","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1002\/cld.1061","article-title":"Global epidemiology of chronic liver disease","volume":"17","author":"Cheemerla","year":"2021","journal-title":"Clin Liver Dis (Hoboken)"},{"key":"10.25259\/ijn_333_23\/ref-5","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1016\/S2468-1253(19)30349-8","article-title":"The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990\u20132017: A systematic analysis for the Global Burden of Disease Study 2017","volume":"5","author":"Sepanlou","year":"2020","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"10.25259\/ijn_333_23\/ref-6","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1097\/MEG.0000000000002520","article-title":"Acute kidney injury development and impact on clinical and economic outcomes in patients with cirrhosis: An observational cohort study over a 10-year period","volume":"35","author":"Alshogran","year":"2023","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"10.25259\/ijn_333_23\/ref-7","first-page":"1058","article-title":"Acute kidney injury in acute-on-chronic liver failure: where does hepatorenal syndrome fit?","volume-title":"Kidney International","volume":"92","author":"Davenport","year":"2017"},{"key":"10.25259\/ijn_333_23\/ref-8","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1093\/gastro\/gox009","article-title":"Renal dysfunction in cirrhosis: acute kidney injury and the hepatorenal syndrome","volume":"5","author":"Bucsics","year":"2017","journal-title":"Gastroenterol Rep (Oxf)"},{"key":"10.25259\/ijn_333_23\/ref-9","doi-asserted-by":"publisher","first-page":"753","DOI":"10.1002\/hep.25735","article-title":"Association of AKI with mortality and complications in hospitalized patients with cirrhosis","volume":"57","author":"Belcher","year":"2013","journal-title":"Hepatology"},{"key":"10.25259\/ijn_333_23\/ref-11","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1002\/lt.21682","article-title":"Acute kidney injury following liver transplantation: Definition and outcome","volume":"15","author":"Barri","year":"2009","journal-title":"Liver Transpl"},{"key":"10.25259\/ijn_333_23\/ref-12","doi-asserted-by":"publisher","first-page":"2064","DOI":"10.1002\/hep.22605","article-title":"Acute kidney injury in cirrhosis","volume":"48","author":"Garcia-Tsao","year":"2008","journal-title":"Hepatology"},{"key":"10.25259\/ijn_333_23\/ref-13","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1136\/jim-d-15-00181","article-title":"Hepatorenal syndrome in hospitalized patients with chronic liver disease: Results from the Nationwide Inpatient Sample 2002-2012","volume":"64","author":"Pant","year":"2016","journal-title":"J Investig Med"},{"key":"10.25259\/ijn_333_23\/ref-14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/0886022X.2022.2142137","article-title":"Impact of acute kidney injury on the risk of mortality in patients with cirrhosis: A systematic review and meta-analysis","volume":"44","author":"Ning","year":"2022","journal-title":"Ren Fail"},{"key":"10.25259\/ijn_333_23\/ref-15","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8030372","article-title":"Incidence and impact of acute kidney injury after liver transplantation: A meta-analysis","volume":"8","author":"Thongprayoon","year":"2019","journal-title":"J Clin Med"},{"key":"10.25259\/ijn_333_23\/ref-16","doi-asserted-by":"publisher","first-page":"1408","DOI":"10.1016\/j.jhep.2023.07.010","article-title":"Incidence and outcomes of acute kidney injury including hepatorenal syndrome in hospitalized patients with cirrhosis in the US","volume":"79","author":"Patidar","year":"2023","journal-title":"J Hepatol"},{"key":"10.25259\/ijn_333_23\/ref-17","doi-asserted-by":"publisher","first-page":"e1001680","DOI":"10.1371\/journal.pmed.1001680","article-title":"Association of non-alcoholic fatty liver disease with chronic kidney disease: A systematic review and meta-analysis","volume":"11","author":"Musso","year":"2014","journal-title":"PLoS Med"},{"key":"10.25259\/ijn_333_23\/ref-18","doi-asserted-by":"publisher","first-page":"430","DOI":"10.4093\/dmj.2017.41.6.430","article-title":"Non-Alcoholic Fatty Liver Disease: The Emerging Burden in Cardiometabolic and Renal Diseases","volume":"41","author":"Han","year":"2017","journal-title":"Diabetes Metab J"},{"key":"10.25259\/ijn_333_23\/ref-19","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1681\/ASN.2004070539","article-title":"Chronic kidney disease awareness, prevalence, and trends among U.S. adults, 1999 to 2000","volume":"16","author":"Coresh","year":"2005","journal-title":"Journal of the American Society of Nephrology"},{"key":"10.25259\/ijn_333_23\/ref-20","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1111\/j.1872-034X.2007.00148.x","article-title":"Regulatory processes interacting to maintain hepatic blood flow constancy: Vascular compliance, hepatic arterial buffer response, hepatorenal reflex, liver regeneration, escape from vasoconstriction","volume":"37","author":"Lautt","year":"2007","journal-title":"Hepatol Res"},{"key":"10.25259\/ijn_333_23\/ref-21","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1056\/NEJMra2215289","article-title":"Acute kidney injury in patients with cirrhosis","volume":"388","author":"Nadim","year":"2023","journal-title":"New England Journal of Medicine"},{"key":"10.25259\/ijn_333_23\/ref-22","doi-asserted-by":"publisher","first-page":"208","DOI":"10.4254\/wjh.v2.i6.208","article-title":"Physiopathology of splanchnic vasodilation in portal hypertension","volume":"2","author":"Martell","year":"2010","journal-title":"World J Hepatol"},{"key":"10.25259\/ijn_333_23\/ref-23","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1056\/NEJM199808203390807","article-title":"Nitric oxide as a mediator of hemodynamic abnormalities and sodium and water retention in cirrhosis","volume":"339","author":"Martin","year":"1998","journal-title":"N Engl J Med"},{"key":"10.25259\/ijn_333_23\/ref-25","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1002\/hep.1840180322","article-title":"Role of prostacyclin in hemodynamic alterations in conscious rats with extrahepatic or intrahepatic portal hypertension","volume":"18","author":"Oberti","year":"1993","journal-title":"Hepatology"},{"key":"10.25259\/ijn_333_23\/ref-26","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1136\/gut.2009.180570","article-title":"Low cardiac output predicts development of hepatorenal syndrome and survival in patients with cirrhosis and ascites","volume":"59","author":"Krag","year":"2010","journal-title":"Gut"},{"key":"10.25259\/ijn_333_23\/ref-27","doi-asserted-by":"publisher","first-page":"1674","DOI":"10.2215\/CJN.03040322","article-title":"Acute kidney injury in patients with liver disease","volume":"17","author":"Cullaro","year":"2022","journal-title":"Clinical Journal of the American Society of Nephrology"},{"key":"10.25259\/ijn_333_23\/ref-28","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/cc646","article-title":"Abdominal compartment syndrome","volume":"4","author":"Bailey","year":"2000","journal-title":"Crit Care"},{"key":"10.25259\/ijn_333_23\/ref-29","doi-asserted-by":"publisher","first-page":"874","DOI":"10.1097\/00005373-200005000-00010","article-title":"Effects of increased renal parenchymal pressure on renal function","volume":"48","author":"Doty","year":"2000","journal-title":"J Trauma"},{"key":"10.25259\/ijn_333_23\/ref-30","first-page":"253","article-title":"The renal hemodynamic and functional effects of external counterpressure","volume":"134","author":"Shenasky","year":"1972","journal-title":"Surg Gynecol Obstet"},{"key":"10.25259\/ijn_333_23\/ref-31","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1111\/j.1478-3231.2008.01877.x","article-title":"Serum creatinine and bilirubin predict renal failure and mortality in patients with spontaneous bacterial peritonitis: a retrospective study","volume":"29","author":"Terg","year":"2009","journal-title":"Liver Int"},{"key":"10.25259\/ijn_333_23\/ref-32","first-page":"229","article-title":"Strong association between IgA nephropathy and hepatitis B surface antigenemia in endemic areas","volume":"29","author":"Lai","year":"1988","journal-title":"Clin Nephrol"},{"key":"10.25259\/ijn_333_23\/ref-33","doi-asserted-by":"publisher","first-page":"5783","DOI":"10.3748\/wjg.v13.i43.5783","article-title":"Association of liver cirrhosis related IgA nephropathy with portal hypertension","volume":"13","author":"Kalambokis","year":"2007","journal-title":"World J Gastroenterol"},{"key":"10.25259\/ijn_333_23\/ref-34","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1007\/s13730-014-0158-6","article-title":"Clinical remission of IgA nephropathy in an HIV-positive patient after combined treatment with tonsillectomy and steroid pulse therapy","volume":"4","author":"Tada","year":"2015","journal-title":"CEN Case Rep"},{"key":"10.25259\/ijn_333_23\/ref-35","doi-asserted-by":"publisher","first-page":"712","DOI":"10.1007\/BF02849965","article-title":"Midodrine: insidious development of urologic adverse effects in patients with spinal cord injury: A report of 2 cases","volume":"24","author":"Vaidyanathan","year":"2007","journal-title":"Adv Ther"},{"key":"10.25259\/ijn_333_23\/ref-36","doi-asserted-by":"publisher","first-page":"R29","DOI":"10.1186\/cc12510","article-title":"Additive value of blood neutrophil gelatinase-associated lipocalin to clinical judgement in acute kidney injury diagnosis and mortality prediction in patients hospitalized from the emergency department","volume":"17","author":"Di Somma","year":"2013","journal-title":"Crit Care"},{"key":"10.25259\/ijn_333_23\/ref-37","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1046\/j.1523-1755.2002.00433.x","article-title":"Kidney Injury Molecule-1 (KIM-1): A novel biomarker for human renal proximal tubule injury","volume":"62","author":"Han","year":"2002","journal-title":"Kidney Int"},{"key":"10.25259\/ijn_333_23\/ref-38","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1002\/hep.26980","article-title":"Kidney biomarkers and differential diagnosis of patients with cirrhosis and acute kidney injury","volume":"60","author":"Belcher","year":"2014","journal-title":"Hepatology"},{"key":"10.25259\/ijn_333_23\/ref-39","doi-asserted-by":"publisher","first-page":"2185468","DOI":"10.1080\/0886022X.2023.2185468","article-title":"Hepatorenal syndrome misdiagnosis may be reduced using inferior vena cava ultrasound to assess intravascular volume and guide management","volume":"45","author":"Kaptein","year":"2023","journal-title":"Ren Fail"},{"key":"10.25259\/ijn_333_23\/ref-40","doi-asserted-by":"publisher","first-page":"968","DOI":"10.1016\/j.jhep.2014.12.029","article-title":"Diagnosis and management of acute kidney injury in patients with cirrhosis: Revised consensus recommendations of the International Club of Ascites","volume":"62","author":"Angeli","year":"2015","journal-title":"J Hepatol"},{"key":"10.25259\/ijn_333_23\/ref-41","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1093\/gastro\/gov032","article-title":"The efficacy and safety profile of albumin administration for patients with cirrhosis at high risk of hepatorenal syndrome is dose dependent","volume":"3","author":"Afinogenova","year":"2015","journal-title":"Gastroenterol Rep (Oxf)"},{"key":"10.25259\/ijn_333_23\/ref-42","doi-asserted-by":"publisher","first-page":"818","DOI":"10.1056\/NEJMoa2008290","article-title":"Terlipressin plus albumin for the treatment of type 1 hepatorenal syndrome","volume":"384","author":"Wong","year":"2021","journal-title":"New England Journal of Medicine"},{"key":"10.25259\/ijn_333_23\/ref-43","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.1002\/lt.26072","article-title":"The current management of hepatorenal syndrome-acute kidney injury in the United States and the potential of terlipressin","volume":"27","author":"Flamm","year":"2021","journal-title":"Liver Transpl"},{"key":"10.25259\/ijn_333_23\/ref-44","doi-asserted-by":"publisher","first-page":"195","DOI":"10.14218\/JCTH.2015.00015","article-title":"Acute kidney injury in patients with cirrhosis","volume":"3","author":"Russ","year":"2015","journal-title":"J Clin Transl Hepatol"},{"key":"10.25259\/ijn_333_23\/ref-45","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1159\/000441151","article-title":"Hepatorenal acute kidney injury and the importance of raising mean arterial pressure","volume":"131","author":"Velez","year":"2015","journal-title":"Nephron"},{"key":"10.25259\/ijn_333_23\/ref-46","doi-asserted-by":"publisher","first-page":"28","DOI":"10.4292\/wjgpt.v6.i3.28","article-title":"Current position of vasoconstrictor and albumin infusion for type 1 hepatorenal syndrome","volume":"6","author":"Sobhonslidsuk","year":"2015","journal-title":"World J Gastrointest Pharmacol Ther"},{"key":"10.25259\/ijn_333_23\/ref-47","doi-asserted-by":"publisher","first-page":"941","DOI":"10.1053\/jhep.2002.35819","article-title":"Terlipressin therapy with and without albumin for patients with hepatorenal syndrome: Results of a prospective, nonrandomized study","volume":"36","author":"Ortega","year":"2002","journal-title":"Hepatology"},{"key":"10.25259\/ijn_333_23\/ref-48","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1097\/01.CCM.0B013E3181611F552","article-title":"Continuous versus intermittent renal replacement therapy for critically ill patients with acute kidney injury: A meta-analysis","volume":"36","author":"Bagshaw","year":"2008","journal-title":"Crit Care Med"},{"key":"10.25259\/ijn_333_23\/ref-49","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1186\/1471-2369-11-32","article-title":"The hemodynamic tolerability and feasibility of sustained low efficiency dialysis in the management of critically ill patients with acute kidney injury","volume":"11","author":"Fieghen","year":"2010","journal-title":"BMC Nephrol"},{"key":"10.25259\/ijn_333_23\/ref-50","doi-asserted-by":"publisher","first-page":"108139","DOI":"10.1155\/2015\/108139","article-title":"Prognosis of Acute kidney injury and hepatorenal syndrome in patients with cirrhosis: A prospective cohort study","volume":"2015","author":"Allegretti","year":"2015","journal-title":"Int J Nephrol"},{"key":"10.25259\/ijn_333_23\/ref-51","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1002\/lt.23384","article-title":"Impact of the etiology of acute kidney injury on outcomes following liver transplantation: Acute tubular necrosis versus hepatorenal syndrome","volume":"18","author":"Nadim","year":"2012","journal-title":"Liver Transplantation"},{"key":"10.25259\/ijn_333_23\/ref-52","doi-asserted-by":"publisher","first-page":"1279","DOI":"10.1056\/NEJMra0809139","article-title":"Renal failure in cirrhosis","volume":"361","author":"Gin\u00e8s","year":"2009","journal-title":"N Engl J Me"},{"key":"10.25259\/ijn_333_23\/ref-53","doi-asserted-by":"publisher","first-page":"810","DOI":"10.1111\/jvh.13287","article-title":"Prevalence and short-term outcome of acute kidney injury in patients with acute-on-chronic liver failure: A meta-analysis","volume":"27","author":"Jiang","year":"2020","journal-title":"J Viral Hepat"},{"key":"10.25259\/ijn_333_23\/ref-54","doi-asserted-by":"publisher","first-page":"818","DOI":"10.1056\/NEJMoa2008290","article-title":"Terlipressin plus albumin for the treatment of type 1 hepatorenal syndrome","volume":"384","author":"Wong","year":"2021","journal-title":"N Engl J Me"},{"key":"10.25259\/ijn_333_23\/ref-55","doi-asserted-by":"publisher","first-page":"736","DOI":"10.1080\/00365520801932944","article-title":"Prediction of survival after liver transplantation by pre-transplant parameters","volume":"43","author":"Weism\u00fcller","year":"2008","journal-title":"Scand J Gastroenterol"},{"key":"10.25259\/ijn_333_23\/ref-56","doi-asserted-by":"publisher","first-page":"2651","DOI":"10.1111\/j.1600-6143.2006.01526.x","article-title":"Continued influence of preoperative renal function on outcome of orthotopic liver transplant (OLTX) in the US: Where will MELD lead us?","volume":"6","author":"Gonwa","year":"2006","journal-title":"Am J Transplant"},{"key":"10.25259\/ijn_333_23\/ref-57","doi-asserted-by":"publisher","first-page":"e12863","DOI":"10.1111\/ctr.12863","article-title":"Impact of acute kidney injury following liver transplantation on long-term outcomes","volume":"31","author":"Trinh","year":"2017","journal-title":"Clin Transplant"}],"container-title":["Indian Journal of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/indianjnephrol.org\/acute-kidney-injury-in-patients-with-chronic-liver-disease-a-review\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/indianjnephrol.org\/acute-kidney-injury-in-patients-with-chronic-liver-disease-a-review\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,4]],"date-time":"2025-01-04T10:31:00Z","timestamp":1735986660000},"score":1,"resource":{"primary":{"URL":"https:\/\/indianjnephrol.org\/acute-kidney-injury-in-patients-with-chronic-liver-disease-a-review\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,24]]},"references-count":55,"alternative-id":["10.25259\/ijn_333_23"],"URL":"https:\/\/doi.org\/10.25259\/ijn_333_23","relation":{},"ISSN":["1998-3662","0971-4065"],"issn-type":[{"type":"electronic","value":"1998-3662"},{"type":"print","value":"0971-4065"}],"subject":[],"published":{"date-parts":[[2024,6,24]]},"article-number":"21"}}