Securing the diagnosis of HRS-AKI: implications for current therapies.

IF 3.8 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Expert Review of Gastroenterology & Hepatology Pub Date : 2023-12-01 Epub Date: 2024-01-17 DOI:10.1080/17474124.2023.2284189

Arpan Mohanty, Andrés Cárdenas

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引用次数: 0

Abstract

Introduction: Hepatorenal syndrome (HRS)-acute kidney injury (HRS-AKI) is a specific type of kidney injury seen in patients with cirrhosis and ascites and is associated with high mortality and morbidity. It is characterized by rapid deterioration of renal function due to reduced renal blood flow secondary to portal hypertensive splanchnic and systemic vasodilation. Early diagnosis and treatment of HRS-AKI are associated with greater likelihood of improvement in renal function, lower need for dialysis, and better post-transplant outcomes.

Areas covered: This review discusses the diagnostic criteria for HRS-AKI, which has undergone several key changes over the last decade, with an aim to secure an early diagnosis and aid swift treatment initiation. Additionally, this review outlines the current treatment paradigms for HRS-AKI.

Expert opinion: In the last 20 years, there have been several advances in understanding the pathophysiology and natural course of HRS-AKI. These have led to critical changes in its definition and diagnostic algorithm. However, prognosis of HRS-AKI remains dismal with no significant improvement in HRS-AKI reversal or HRS-related mortality over this time. We discuss several gaps in the current understanding and management of HRS-AKI that will benefit from further research.

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确保rs - aki的诊断:对当前治疗的影响。

肝肾综合征(HRS)-急性肾损伤(HRS- aki)是一种特殊类型的肾损伤，见于肝硬化和腹水患者，具有高死亡率和发病率。它的特点是由于继发于门静脉高压、内脏和全身血管扩张的肾血流量减少而导致肾功能迅速恶化。HRS-AKI的早期诊断和治疗与肾功能改善的可能性更大、透析需求更低和移植后预后更好相关。涵盖领域:本综述讨论了rs - aki的诊断标准，该标准在过去十年中经历了几次关键变化，目的是确保早期诊断并帮助快速开始治疗。此外，这篇综述概述了目前的治疗范例rs - aki。专家意见:在过去的20年里，在了解rs - aki的病理生理和自然过程方面取得了一些进展。这些导致了其定义和诊断算法的重大变化。然而，rs - aki的预后仍然令人沮丧，在这段时间内rs - aki逆转或rs相关死亡率没有显著改善。我们讨论了目前对rs - aki的理解和管理中的几个空白，这些空白将从进一步的研究中受益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Gastroenterology & Hepatology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

6.80

自引率

2.60%

发文量

审稿时长

6-12 weeks

期刊介绍： The enormous health and economic burden of gastrointestinal disease worldwide warrants a sharp focus on the etiology, epidemiology, prevention, diagnosis, treatment and development of new therapies. By the end of the last century we had seen enormous advances, both in technologies to visualize disease and in curative therapies in areas such as gastric ulcer, with the advent first of the H2-antagonists and then the proton pump inhibitors - clear examples of how advances in medicine can massively benefit the patient. Nevertheless, specialists face ongoing challenges from a wide array of diseases of diverse etiology.