title: Current limits and future challenges in the management of renal dysfunction in patients with cirrhosis: report from the International Club of Ascites.
abstract: Advanced cirrhosis is often complicated by a multi organ failure syndrome which involves many different organs besides the liver. The high morbidity and mortality secondary to this clinical setting is often related to renal dysfunction, either alone or, more frequently, in combination with other organ dysfunction. A clear definition of renal dysfunction, an accurate differential diagnostic process of its different phenotypes as well as of full understanding of its pathophysiological mechanisms are crucial to the development of strategies for the management of this complication. This article is based either on the more recent knowledge on renal dysfunction in advanced cirrhosis or current opinions among the members of the International Club of Ascites (ICA) on the management of this complication, obtained through a survey and discussed during the EASL-ICA Joint Meeting in Berlin in March 2011. It reviews critically our current knowledge and it outlines future perspectives, on the management of renal dysfunction in patients with cirrhosis.
authors.affiliation: Department of Medicine, Unit of Hepatic Emergencies and Liver Transplantation, University of Padova, Padova, Italy. pangeli@unipd.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Angeli
authors.forename: Arun
authors.initials: A
authors.lastname: Sanyal
authors.forename: Soren
authors.initials: S
authors.lastname: Moller
authors.forename: Carlo
authors.initials: C
authors.lastname: Alessandria
authors.forename: Adrian
authors.initials: A
authors.lastname: Gadano
authors.forename: Ray
authors.initials: R
authors.lastname: Kim
authors.forename: Shiv K
authors.initials: SK
authors.lastname: Sarin
authors.forename: Mauro
authors.initials: M
authors.lastname: Bernardi
mesh_terms: D003937:Diagnosis, Differential; D006530:Hepatorenal Syndrome / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007674:Kidney Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D007677:Kidney Function Tests; D008103:Liver Cirrhosis / Q000150:complications*; D009102:Multiple Organ Failure / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D011237:Predictive Value of Tests; D011379:Prognosis; D012720:Severity of Illness Index