Sound waves and solutions: Point-of-care ultrasonography for acute kidney injury in cirrhosis.

Autor:	Aguirre-Villarreal D; Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico., Leal-Villarreal MAJ; Cardiología, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico., García-Juárez I; Unidad de Hepatología y Trasplante, Departamento de Gastroenterología, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City 14080, Mexico., Argaiz ER; Departamento de Nefrología y Metabolismo Mineral, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico.; Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Mexico City 64710, Mexico., Koratala A; Department of Nephrology, Medical College of Wisconsin, Milwaukee, WI 53226, United States. akoratala@mcw.edu.
Jazyk:	angličtina
Zdroj:	World journal of critical care medicine [World J Crit Care Med] 2024 Jun 09; Vol. 13 (2), pp. 91212. Date of Electronic Publication: 2024 Jun 09 (Print Publication: 2024).
DOI:	10.5492/wjccm.v13.i2.91212
Abstrakt:	This article delves into the intricate challenges of acute kidney injury (AKI) in cirrhosis, a condition fraught with high morbidity and mortality. The complexities arise from distinguishing between various causes of AKI, particularly hemodynamic AKI, in cirrhotic patients, who experience hemodynamic changes due to portal hypertension. The term "hepatocardiorenal syndrome" is introduced to encapsulate the intricate interplay among the liver, heart, and kidneys. The narrative emphasizes the often-overlooked aspect of cardiac function in AKI assessments in cirrhosis, unveiling the prevalence of cirrhotic cardiomyopathy marked by impaired diastolic function. The conventional empiric approach involving volume expansion and vasopressors for hepatorenal syndrome is critically analyzed, highlighting potential risks and variable patient responses. We advocate for a nuanced algorithm for AKI evaluation in cirrhosis, prominently featuring point-of-care ultrasonography (POCUS). POCUS applications encompass assessing fluid tolerance, detecting venous congestion, and evaluating cardiac function. Competing Interests: Conflict-of-interest statement: All authors report no conflicts of interest to declare. (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)
Databáze:	MEDLINE
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