SCCM Resource Library-Maintaining Renal Function in Patients With Cirrhosis: New Guidelines and Evidence in Identification and Management of Hepatorenal Syndrome and Acute Kidney Injury

Video Transcription

Video Summary

The video transcript discusses the management of hepatorenal syndrome (HRS) in patients with liver disease. The speakers cover topics such as the etiologies of acute kidney injury (AKI) and cirrhosis, updated clinical definitions, and the role of biomarkers in assessing AKI. They also discuss the criteria for considering combined liver-kidney transplant and the use of renal replacement therapy in cirrhotic patients. The importance of differentiating between reversible and irreversible AKI and its impact on prognosis and survival post-transplant is emphasized. <br /><br />A specific study on terlipressin, a treatment for HRS, is also discussed. The study compared terlipressin to placebo in patients with decompensated cirrhosis and found that terlipressin was more effective in achieving HRS reversal and improving renal function. It was associated with a lower incidence of renal replacement therapy and shorter ICU stays. Adverse events were common but similar between the two groups. <br /><br />The study highlights the need for early diagnosis and treatment of HRS in improving outcomes for patients. Additionally, the importance of maintaining mean arterial blood pressure and optimizing drug therapy to prevent and treat HRS is underscored. Overall, the video provides an overview of the current understanding of renal function in cirrhosis and the importance of further research in this area.

Asset Subtitle

GI and Nutrition, Renal, 2020

Asset Caption

The Society of Critical Care Medicine's Critical Care Congress features internationally renowned faculty and content sessions highlighting the most up-to-date, evidence-based developments in critical care medicine. This is a presentation from the 2020 Critical Care Congress held February 16-19, 2020, in Orlando, Florida, USA.

This program is supported by an educational grant from Mallinckrodt Pharmaceuticals.

Learning Objectives

Describe current guidelines and position statements for establishing diagnosis of hepatorenal syndrome (HRS) and acute kidney injury (AKI) compared with other AKI etiologies
Apply proactive evidence-based pharmacotherapy to patients who both meet criteria for HRS/AKI and show rapid serum creatinine elevation
Discuss current evidence in maintaining renal function and improving survival for different pharmacologic, interventional, and surgical treatments in the management of HRS/AKI

Hepatorenal Syndrome and Acute Kidney Injury: Current Knowledge and Unmet Needs

Constantine J. Karvellas

New Guidelines for Hepatorenal Syndrome and Acute Kidney Injury: Early Identification and Correct Diagnosis

Jody C. Olson

Evidence-Based Best Practices: Pharmacologic Options for Maintaining Renal Function in Hepatorenal Syndrome and Acute Kidney Injury

William Peppard

Applying Evidence-Based Strategies to the Management of Hepatorenal Syndrome and Acute Kidney Injury in the Critical Care Setting

Constantine J. Karvellas

Meta Tag

Content Type Presentation

Knowledge Area Renal

Knowledge Area GI and Nutrition

Knowledge Level Advanced

Membership Level Select

Membership Level Professional

Membership Level Associate

Tag Liver

Tag Kidney

Year 2020

Keywords

hepatorenal syndrome

HRS management

liver disease

acute kidney injury

cirrhosis

biomarkers

combined liver-kidney transplant

renal replacement therapy

terlipressin study

renal function improvement

early diagnosis

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