This commissioned review article was subject to full peer-review and the authors received an honorarium from Wiley, on behalf of AP&T.
Review article: advances in the management of patients with cirrhosis and portal hypertension-related renal dysfunction
Article first published online: 13 FEB 2014
© 2014 John Wiley & Sons Ltd
Alimentary Pharmacology & Therapeutics
Volume 39, Issue 7, pages 699–711, April 2014
How to Cite
Leithead, J. A., Hayes, P. C. and Ferguson, J. W. (2014), Review article: advances in the management of patients with cirrhosis and portal hypertension-related renal dysfunction. Alimentary Pharmacology & Therapeutics, 39: 699–711. doi: 10.1111/apt.12653
- Issue published online: 3 MAR 2014
- Article first published online: 13 FEB 2014
- Manuscript Accepted: 19 JAN 2014
- Manuscript Revised: 30 DEC 2013
- Manuscript Revised: 12 OCT 2013
- Manuscript Received: 30 SEP 2013
In cirrhosis, portal hypertension is associated with a spectrum of renal dysfunction that has significant implications for morbidity and mortality.
To discuss recent progress in the patho-physiological mechanisms and therapeutic options for portal hypertension-related renal dysfunction.
A literature search using Pubmed was performed.
Portal hypertension-related renal dysfunction occurs in the setting of marked neuro-humoral and circulatory derangement. A systemic inflammatory response is a pathogenetic factor in advanced disease. Such physiological changes render the individual vulnerable to further deterioration of renal function. Patients are primed to develop acute kidney injury when exposed to additional ‘hits’, such as sepsis. Recent progress has been made regarding our understanding of the aetiopathogenesis. However, treatment options once hepatorenal syndrome develops are limited, and prognosis remains poor. Various strategies to prevent acute kidney injury are suggested.
Prevention of acute kidney injury in high risk patients with cirrhosis and portal hypertension-related renal dysfunction should be a clinical priority.