Chronic Kidney Disease and Liver Disease

Milind Y Junghare, Hassan N Ibrahim

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Kidney disease is a common complication in patients with liver disease. The development of kidney disease is associated with significant morbidity and mortality. The interrelationship between the kidneys and the liver is complex, as kidney failure may be functional or structural in nature. Functional renal failure is a common feature in patients with liver disease, due to underlying hepatorenal pathophysiology, marked by splanchnic vasodilation, arterial underfilling and renal vasoconstriction that progresses in patients with decompensated cirrhosis. Functional renal compromise may be further complicated by structural kidney disease associated with either primary liver or systemic disease. Aside from under recognition of decreased GFR due to inaccurate S[Cr]-based estimates, differentiating functional renal impairment from parenchymal injury is problematic. Moreover, the clinical setting of these often critically ill patients, coupled with intense renal vasoconstriction, predisposes them to many types of renal dysfunction and disease. Clinically, varying combinations of both functional and structural kidney disease characterize the spectrum of kidney disease in the patients with liver disease. Clinical status may be further understood by classifying renal failure as acute, chronic or AKI superimposed on chronic kidney disease, but determination of classifications may be indistinct.Understanding the spectrum of kidney disease in the setting of liver failure not only allows for therapy to be individualized but also provides insight regarding the reversibility of kidney disease with implications regarding liver and simultaneous liver-kidney transplantation.

Original languageEnglish (US)
Title of host publicationChronic Renal Disease
PublisherElsevier Inc.
Pages544-559
Number of pages16
ISBN (Electronic)9780124116160
ISBN (Print)9780124116023
DOIs
StatePublished - Jan 1 2015

Keywords

  • Acute kidney injury
  • Chronic kidney disease
  • Cirrhosis
  • Consensus conference guidelines
  • Cryoglobulinemia
  • Hepatitis B
  • Hepatitis C
  • Hepatitis-related renal disease
  • Hepatorenal syndrome
  • Kidney disease
  • Liver dialysis
  • Liver disease
  • Liver failure
  • Liver transplantation
  • Membranoproliferative glomerulonephritis
  • Membranous nephropathy
  • Renal dysfunction
  • Renal failure
  • Renal replacement therapy
  • Simultaneous liver- kidney transplantation
  • Terlipressin
  • Vasoconstrictor therapy

Fingerprint Dive into the research topics of 'Chronic Kidney Disease and Liver Disease'. Together they form a unique fingerprint.

  • Cite this

    Junghare, M. Y., & Ibrahim, H. N. (2015). Chronic Kidney Disease and Liver Disease. In Chronic Renal Disease (pp. 544-559). Elsevier Inc.. https://doi.org/10.1016/B978-0-12-411602-3.00045-7