What a Nephrologist Needs to Know About Acute Liver Failure

Thomas M. Leventhal, Kathleen D. Liu

Research output: Contribution to journalReview articlepeer-review

15 Scopus citations


Although relatively rare in the United States, acute liver failure (ALF) is associated with very high rates of morbidity and mortality. A leading cause of morbidity and mortality is cerebral edema and intracranial hypertension. Hypothermia, osmotic diuretics, and hyperosmolar therapy are commonly used to manage these complications; however, when these are ineffective, renal replacement therapy may be needed for volume management. Acute kidney injury is a common complication of ALF and may arise from a number of etiologies, including hepatorenal syndrome and acute tubular necrosis. Acute kidney injury is most common in patients who develop ALF because of acetaminophen toxicity or ischemia. With regard to renal replacement therapy, we will review specific considerations relevant to the management of the patient with ALF.

Original languageEnglish (US)
Pages (from-to)376-381
Number of pages6
JournalAdvances in Chronic Kidney Disease
Issue number5
StatePublished - 2015
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2015 National Kidney Foundation, Inc..


  • Acetaminophen
  • Dialysis
  • Hepatic failure
  • N-acetylcysteine
  • Renal failure


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