Hepatorenal Syndrome with Acute Kidney Injury (HRS-AKI) Stage >1A in Liver Cirrhosis
This protocol addresses patients with liver cirrhosis who develop hepatorenal syndrome with acute kidney injury (HRS-AKI) at a stage greater than 1A — a serious complication requiring prompt, structured management.
Clinical Situation
All patients meeting the current definition of HRS-AKI stage >1A should be treated expeditiously. Current guidelines recommend vasoconstrictors and albumin for all patients in this setting.
Treatment Approach (Partial)
When patients do not respond to initial vasoconstrictor-based therapy, renal replacement therapy may be considered based on individual severity of illness. Liver transplantation represents the definitive therapeutic option for HRS, irrespective of the response to drug therapy.
Full sequencing, criteria, and complete management algorithm available in the structured protocol.
References
DOI: 10.1016/j.jhep.2018.03.024
- Vasoconstrictors and albumin are recommended in all patients meeting the current definition of AKI-HRS stage >1A, should be expeditiously treated with vasoconstrictors and albumin (III;1).
- LT is the best therapeutic option for patients with HRS regardless of the response to drug therapy (I;1).
- The decision to initiate RRT should be based on the individual severity of illness (I;2).
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