title: What a Nephrologist Needs to Know About Acute Liver Failure.
abstract: Although relatively rare in the United States, acute liver failure (ALF) is associated with very high rates of morbidity and mortality. A leading cause of morbidity and mortality is cerebral edema and intracranial hypertension. Hypothermia, osmotic diuretics, and hyperosmolar therapy are commonly used to manage these complications; however, when these are ineffective, renal replacement therapy may be needed for volume management. Acute kidney injury is a common complication of ALF and may arise from a number of etiologies, including hepatorenal syndrome and acute tubular necrosis. Acute kidney injury is most common in patients who develop ALF because of acetaminophen toxicity or ischemia. With regard to renal replacement therapy, we will review specific considerations relevant to the management of the patient with ALF.
authors: Division of Gastroenterology, Department of Medicine, University of California, San Francisco, CA; Divisions of Nephrology and Critical Care, Departments of Medicine and Anesthesia, University of California, San Francisco, CA.
authors: Thomas M
authors: TM
authors: Leventhal
authors: Division of Gastroenterology, Department of Medicine, University of California, San Francisco, CA; Divisions of Nephrology and Critical Care, Departments of Medicine and Anesthesia, University of California, San Francisco, CA. Electronic address: kathleen.liu@ucsf.edu.
authors: Kathleen D
authors: KD
authors: Liu
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D002983:Clinical Competence; D003131:Combined Modality Therapy; D015897:Comorbidity; D005260:Female; D006801:Humans; D017114:Liver Failure, Acute / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D016031:Liver Transplantation / Q000379:methods; D008297:Male; D009398:Nephrology / Q000379:methods; D010819:Physician's Role; D010818:Practice Patterns, Physicians'; D011379:Prognosis; D006435:Renal Dialysis / Q000379:methods*; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate
keywords: Acetaminophen; Dialysis; Hepatic failure; N-acetylcysteine; Renal failure