肝硬化患者容易发生急性肾损伤(AKI),与住院发病率和死亡率显着增加相关的并发症,以及进展为慢性肾病的风险。尽管肝硬化患者发生AKI任何表型的风险增加,肝肾综合征(HRS),AKI(HRS-AKI)在晚期肝硬化和腹水患者的一种特殊形式,具有特别高的死亡风险。早期识别HRS-AKI至关重要,因为内脏血管收缩剂的给药可以逆转AKI,并作为肝移植的桥梁。唯一的治疗选择。2023年,召开了国际腹水俱乐部(ICA)和急性疾病质量倡议(ADQI)的联席会议,以制定HRS-AKI的新诊断标准。为工作提供分级建议,肝硬化和AKI患者的管理和出院后随访,并强调进一步研究的优先事项。
Patients with cirrhosis are prone to developing acute kidney injury (AKI), a complication associated with a markedly increased in-hospital morbidity and mortality, along with a risk of progression to chronic kidney disease. Whereas patients with cirrhosis are at increased risk of developing any phenotype of AKI, hepatorenal syndrome (HRS), a specific form of AKI (HRS-AKI) in patients with advanced cirrhosis and ascites, carries an especially high mortality risk. Early recognition of HRS-AKI is crucial since administration of splanchnic vasoconstrictors may reverse the AKI and serve as a bridge to liver transplantation, the only curative option. In 2023, a joint meeting of the International Club of Ascites (ICA) and the Acute Disease Quality Initiative (ADQI) was convened to develop new diagnostic criteria for HRS-AKI, to provide graded recommendations for the work-up, management and post-discharge follow-up of patients with cirrhosis and AKI, and to highlight priorities for further research.