Continuous renal replacement therapies in patients with liver disease.
Patients with acute and chronic liver disease are prone to hypotension, and mortality increases when acute kidney injury supervenes. Hypotension during renal replacement therapy compromises cerebral perfusion, which can exacerbate cerebral edema in cases of fulminant hepatic failure and those with encephalopathy due to chronic liver failure. As such, any renal replacement therapy utilized should have minimal adverse effects on cardiovascular and cerebrovascular stability. Continuous modes of renal replacement therapy have been shown to cause less cardiovascular and cerebrovascular instability compared to other modalities, and as such are the treatments of choice for this group of critically ill patients.
UCL Center for Nephrology, Royal Free & University College Medical School, Hampstead Campus, Rowland Hill Street, London, UK. andrew.davenport@royalfree.nhs.uk
Andrew
A
Davenport
D058186:Acute Kidney Injury / Q000150:complications / Q000628:therapy*; D006801:Humans; D008107:Liver Diseases / Q000150:complications* / Q000628:therapy; D016031:Liver Transplantation; D017582:Renal Replacement Therapy / Q000379:methods*; D016896:Treatment Outcome