Kim Moon Young, Seo Yeon Seok
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Korean J Gastroenterol. 2018 Aug 25;72(2):64-73. doi: 10.4166/kjg.2018.72.2.64.
Acute kidney injury (AKI) is common in patients with liver cirrhosis, occurring in 13-20% of patients hospitalized with decompensated cirrhosis, and is significantly associated with the prognosis. The development and progression of AKI is an independent predictive factor for mortality in these patients. If AKI develops, the renal function declines progressively even if AKI is improved later, the patients have a poorer prognosis compared to those who have not developed AKI. In addition, in patients without appropriate treatment or no improvement with the initial treatment, AKI often progress to hepatorenal syndrome (HRS), which is associated with significant morbidity and mortality. Therefore, early detection and appropriate management for the development of AKI is very important in these patients. Recently, there have been significant revisions in the diagnostic criteria and treatment of AKI and HRS; this manuscript reviews these changes.
急性肾损伤（AKI）在肝硬化患者中很常见，在失代偿性肝硬化住院患者中发生率为13%-20%，且与预后显著相关。AKI的发生和进展是这些患者死亡的独立预测因素。如果发生AKI，即使后期AKI有所改善，肾功能仍会逐渐下降，与未发生AKI的患者相比，这些患者的预后更差。此外，在未接受适当治疗或初始治疗无改善的患者中，AKI常进展为肝肾综合征（HRS），这与显著的发病率和死亡率相关。因此，对这些患者早期发现AKI并进行适当管理非常重要。最近，AKI和HRS的诊断标准及治疗有了重大修订；本文对这些变化进行综述。
