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Gastroenterologie
a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2019; 73(3): 250–256. doi:10.14735/amgh2019250.

Renal complications of acute and chronic liver disease

Miroslav Merta1

+ Affiliation

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, chronic kidney disease, cirrhosis, hepatorenal syndrome, non-alcoholic fatty liver disease

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Literature

1. Coelho S, Fonseca JN, Gameiro J et al. Transient and persistent acute kidney injury in acute liver failure. J Nephrol 2019; 32 (2): 289–296. doi: 10.1007/s40620-018-00568-w.
2. Pyrsopoulos NT, Reddy KR. Extrahepatic manifestations of chronic viral hepatitis. Curr Gastroenterol Rep 2001; 3 (1): 71–78.
3. Cho EJ, Kim SE, Suk KT et al. Current status and strategies for hepatitis B control in Korea. Clin Mol Hepatol 2017; 23 (3): 205–211. doi: 10.3350/cmh.2017.0104.
4. Kim SE, Jang ES, Ki M et al. Chronic hepatitis B infection is significantly associated with chronic kidney disease: a population-based, matched case-control study. J Korean Med Sci 2018; 33 (42): e264. doi: 10.3346/jkms.2018.33. e264.
5. Husa P, Šperl J, Urbánek P et al. Doporučený postup diagnostiky a léčby infekce virové hepatitidy B. Gastroenterol Hepatol 2017; 71 (5): 419–437. doi: 10.14735/amgh2017419.
6. Cottone C, Bhamidimarri KR. Evaluating CKD/ESRD patient with hepatitis C infection: how to interpret diagnostic testing and assess liver injury. Semin Dial 2019; 32 (2): 119–126. doi: 10.1111/sdi.12760.
7. Lee JJ, Lin MY, Chang JS et al. Hepatitis C virus infection increases risk of developing end-stage renal disease using competing risk analysis. PLoS One 2014; 9 (6): e100790. doi: 10.1371/journal.pone.0100790.
8. KDIGO 2018 clinical practice guideline for the prevention, diagnosis, evaluation, and treatment of hepatitis C in chronic kidney disease. [online]. Available from: https: //www.kisupplements.org/article/S2157-1716 (18) 30005-4/fulltext.
9. Urbánek P, Fraňková S, Husa P et al. Standardní diagnostický a terapeutický postup chronické infekce virem hepatitidy C (HCV). Gastroenterol Hepatol 2019; 73 (2): 101–125. doi: 10.14735/amgh2019101.
10. Guinault D, Ribes D, Delas A et al. Hepatitis E virus-induced cryoglobulinemic glomerulonephritis in a nonimmunocompromised person. Am J Kidney Dis 2016; 67 (4): 660–663. doi: 10.1053/j.ajkd.2015.10.022.
11. Amin AA, Alabsawy EI, Jalan R et al. Epidemiology, pathophysiology, and management of hepatorenal syndrome. Semin Nephrol 2019; 39 (1): 17–30. doi: 10.1016/j.semnephrol.2018.10. 002.
12. Angeli P, Ginès P, Wong F et al. Diagnosis and management of acute kidney injury in patients with cirrhosis: revised consensus recommendations of the International Club of Ascites. J Hepatol 2015; 62 (4): 968–974. doi: 10.1016/j.jhep.2014.12.029.
13. KDIGO clinical practice guideline for acute kidney injury. Kidney Int 2012; 2 (Suppl 1): 1–141.
14. KDIGO clinical practice guideline for the evaluation and management od chronic kidney disease. Kidney Int 2013; 3 (Suppl 1): 1–150.
15. Solé C, Solà E, Huelin P et al. Characterization of inflammatory response in hepatorenal syndrome: relationship with kidney outcome and survival. Liver Int 2019; 00: 1–10. doi: 10.1111/liv.14037.
16. Durand F, Graupera I, Ginès P et al. Pathogenesis of hepatorenal syndrome: implications for therapy. Am J Kidney Dis 2016; 67 (2): 318–328. doi: 10.1053/j.ajkd.2015.09.013.
17. Mehta G, Mookerjee RP, Sharma V et al. Systemic inflammation is associated with increased intrahepatic resistance and mortality in alcohol-related acute-on-chronic liver failure. Liver Int 2015; 35 (3): 724–734. doi: 10.1111/liv.12559.
18. Piano S, Rosi S, Maresio G et al. Evaluation of the acute kidney injury network criteria in hospitalized patients with cirrhosis and ascites. J Hepatol 2013; 59 (3): 482–489. doi: 10.1016/j.jhep.2013.03.039.
19. Fede G, D’Amico G, Arvaniti V et al. Renal failure and cirrhosis: a systematic review of mortality and prognosis. J Hepatol 2012; 56 (4): 810–818. doi: 10.1016/j.jhep.2011.10.016.
20. Francoz C, Nadim MK, Durand F. Kidney biomarkers in cirrhosis. J Hepatol 2016; 65 (4): 809–824. doi: 10.1016/j.jhep.2016.05.025.
21. MacDonald AJ, Nadim MK, Durand F et al. Acute kidney injury in cirrhosis: implications for liver transplantation. Curr Opin Crit Care 2019; 25 (2): 171–178. doi: 10.1097/MCC.0000000000 000590.
22. Mindikoglu AL, Dowling TC, Magder LS et al. Estimation of glomerular filtration rate in patients with cirrhosis by using new and conventional filtration markers and dimethylarginines. Clin Gastroenterol Hepatol 2016; 14 (4): 624–632. doi: 10.1016/j.cgh.2015.06.021.
23. Asrani SK, Jennings LW, Trotter JF et al. A model for glomerular filtration rate assessment in liver disease (GRAIL) in the presence of renal dysfunction. Hepatology 2019; 69 (3): 1219–1230. doi: 10.1002/hep.30321.
24. Wong F, Reddy KR, O’Leary JG et al. Impact of chronic kidney disease on outcomes in cirrhosis. Liver Transpl 2019; 25 (6): 870-880. doi: 10.1002/lt.25454.
25. Warner NS, Cuthbert JA, Bhore R et al. Acute kidney injury and chronic kidney dis-ease in hospitalized patients with cirrhosis. J Investig Med 2011; 59 (8): 1244–1251. doi: 10.2130/JIM.0b013e3182321471.
26. Younossi ZM. Non-alcoholic fatty liver dis-ease – a global public health perspective. J Hepatol 2019; 70 (3): 531–544. doi: 10.1016/j.jhep.2018.10.033.
27. Younossi ZM, Koenig AB, Abdelatif D et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology 2016; 64 (1): 73–84. doi: 10.1002/hep.28431.
28. Loomba R, Sanyal AJ. The global NAFLD  epidemic. Nat Rev Gastroenterol Hepatol 2013; 10 (11): 686–690. doi: 10.1038/nrgastro.2013.171.
29. Targher G, Byrne CD. Non-alcoholic fatty liver disease: an emerging driving force in chronic kidney disease. Nat Rev Nephrol 2017; 13 (5): 297–310. doi: 10.1038/nrneph.2017.16.
30. Meraz-Muñoz A, García-Juárez I. Chronic kidney disease in liver transplantation: evaluation of kidney function. Rev Gastroenterol Mex 2019; 84 (1): 57–68. doi: 10.1016/j.rgmx.2018.07.002.
31. Charlton MR, Wall WJ, Ojo AO et al. Report of the first international liver transplantation society expert panel consensus conference on renal insufficiency in liver transplantation. Liver Transpl 2009; 15 (11): S1–S34. doi: 10.1002/lt.21877.
32. Nair S, Verma S, Thuluvath PJ. Pretransplant renal function predicts survival in patients undergoing orthotopic liver transplantation. Hepatology 2002; 35 (5): 1179–1185. doi: 10.1053/jhep.2002.33160.
33. Kamath PS, Wiesner RH, Malinchoc M et al. A model to predict survival in patients with end-stage liver disease. Hepatology 2001; 33 (2): 464–470. doi: 10.1053/jhep.2001.22172.
34. Sharma P, Schaubel DE, Guidinger MK. Impact of MELD-based allocation on end-stage renal disease after liver transplantation. Am J Transplant 2011; 11 (11): 2372–2378. doi: 10.1111/j.1600-6143.2011.03703.x.
35. Gonwa TA, McBride MA, Anderson K. Continued influence of preoperative renal function on outcome of orthotopic liver transplant (OLTX) in the US: where will MELD lead us? Am J Transplant 2006; 6 (11): 2651–2659. doi: 10.1111/j.1600-6143.2006.01526.x.
36. Thongprayoon C, Kaewput W, Thamcharoen N et al. Incidence and impact of acute kidney injury after liver transplantation: a meta-analysis. J Clin Med 2019; 8 (3): pii E372. doi: 10.3390/jcm8030372.
37. Sharma P, Welch K, Eikstadt R et al. Renal outcomes after liver transplantation in the model for end-stage liver disease era. Liver Transpl 2009; 15 (9): 1142–1148. doi: 10.1002/lt.21821.
38. Li Y, Li B, Wang W et al. Risk factors for new-onset chronic kidney disease in patients who have received a liver transplant. Exp Ther Med 2018; 15 (4): 3589–3595. doi: 10.3892/etm.2018.5823.
39. Sharma P, Goodrich NP, Schaubel DE et al. Patient-specific prediction of ESRD after liver transplantation. J Am Soc Nephrol 2013; 24 (12): 2045–2052. doi: 10.1681/ASN.2013040436.

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