Renal complications of acute and chronic liver disease

Česká verzia

Authors: Merta M.
Published in the journal: Gastroent Hepatol 2019; 73(3): 250-256
Category:
doi: https://doi.org/10.14735/amgh2019250

Summary

The liver and kidneys are commonly injured concomitantly. Such dual impairment can manifest in different forms. Recent knowledge suggests that common mechanisms are involved in the pathogenesis of renal and hepatic injury and that it is sensible to emphasize the systemic nature and ominous prognosis of dual organ injury, rather than to consider these two types of injury in isolation. In cases of liver cirrhosis, acute kidney injury (AKI) is associated with a significant increase in mortality and is an important factor when assessing eligibility for liver transplantation. Hepatorenal syndrome is primarily a purely hemodynamic phenomenon accompanied by inflammatory and systemic changes in the kidneys and other organs. This syndrome often underlies AKI in cases of liver cirrhosis; however, other types of AKI are gaining growing attention and being increasingly recognized. In cases of chronic liver disease, the relationship between non-alcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD) has been studied. NAFLD is currently considered the hepatic component of metabolic syndrome and is negatively associated with cardiovascular disease, diabetes mellitus, and CKD. Close cooperative of renal and hepatic specialists is required for successful management of clinical problems in the liver-kidney axis.

Keywords:

Chronic liver disease – liver cirrhosis – non-alcoholic fatty liver disease – hepatorenal syndrome

Zdroje

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