title: Preventing and Treating Acute Kidney Injury Among Hospitalized Patients with Cirrhosis and Ascites: A Narrative Review.
abstract: Acute kidney injury in the setting of ascites and cirrhosis is a medical emergency characterized by significant morbidity and mortality. Clinicians other than gastroenterologists are often the front line against acute kidney injury for patients with ascites. Owing to the specifics of cirrhotic physiology, the treatment and prevention of acute kidney injury in the setting of ascites has unique features, widespread knowledge of which will benefit our patients with cirrhosis. Early detection and treatment of infection, maximization of cardiac output, and avoidance of medications that limit cardiorenal adaptations to arterial underfilling are part of a multipronged strategy to protect the renal function of our patients with cirrhosis and ascites.
authors.affiliation: Division of Gastroenterology/Hepatology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass. Electronic address: etapper@bidmc.harvard.edu.
authors.forename: Elliot B
authors.initials: EB
authors.lastname: Tapper
authors.affiliation: Division of Gastroenterology/Hepatology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass.
authors.forename: Alan
authors.initials: A
authors.lastname: Bonder
authors.affiliation: GI/Liver Unit, Hospital Clinic, Institut de Malalties Digestives i Metaboliques, University of Barcelona, Spain.
authors.forename: Andres
authors.initials: A
authors.lastname: Cardenas
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000517:prevention & control*; D001201:Ascites / Q000150:complications*; D006530:Hepatorenal Syndrome / Q000628:therapy; D006801:Humans; D007297:Inpatients; D008103:Liver Cirrhosis / Q000150:complications*
keywords: Hepatorenal syndrome; Hospitalist; Liver disease; Paracentesis; Spontaneous bacterial peritonitis