Preventing and Treating Acute Kidney Injury Among Hospitalized Patients with Cirrhosis and Ascites: A Narrative Review

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• 作者：Elliot B. Tapper ; MD^a ; ^{etapper@bidmc.harvard.edu" class="auth_mail" title="E-mail the corresponding author} ; Alan Bonder ; MD^a ; Andres Cardenas ; MD ; MMSc ; PhD^b
• 关键词：Hepatorenal syndrome ; Hospitalist ; Liver disease ; Paracentesis ; Spontaneous bacterial peritonitis
• 刊名：The American Journal of Medicine
• 出版年：2016
• 出版时间：May 2016
• 年：2016
• 卷：129
• 期：5
• 页码：461-467
• 全文大小：555 K

文摘

Acute kidney injury in the setting of ascites and cirrhosis is a medical emergency characterized by significant morbidity and mortality. Clinicians other than gastroenterologists are often the front line against acute kidney injury for patients with ascites. Owing to the specifics of cirrhotic physiology, the treatment and prevention of acute kidney injury in the setting of ascites has unique features, widespread knowledge of which will benefit our patients with cirrhosis. Early detection and treatment of infection, maximization of cardiac output, and avoidance of medications that limit cardiorenal adaptations to arterial underfilling are part of a multipronged strategy to protect the renal function of our patients with cirrhosis and ascites.