This protocol addresses portal hypertension in patients with liver cirrhosis who have developed hepatorenal syndrome‑chronic kidney disease (HRS-CKD), defined by a sustained reduction in kidney function in the absence of structural renal disease.
The patient has cirrhosis with an eGFR below 60 mL/min/1.73 m² persisting for more than three months, and no underlying structural renal disease is identified. This pattern meets the criteria for HRS-CKD, a specific form of kidney impairment seen in the context of advanced liver disease.
For patients meeting the HRS-CKD criteria with progressive renal deterioration, a combined surgical transplant strategy is considered. The complete eligibility criteria, workup requirements, and sequencing are detailed in the full protocol.
DOI: 10.1016/j.jceh.2022.03.002
If the eGFR is less than 60 mL/min/1.73 m2 for more than three months in the absence of structural renal disease, then the patient is labeled as HRS-CKD.
Patients with GFR <60 ml/min for >90 days and subsequent GFR <30 ml/min or requirement for dialysis are candidates for simultaneous liver-kidney transplant (SLKT).
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