Renal dysfunction in cirrhosis is not just a vasomotor nephropathy
The short-term mortality of cirrhotic patients who develop renal dysfunction remains unacceptably high, and as such the treatment of this condition is an unmet need. Although features of kidney injury are well recognized in these patients, the pathophysiology is complex and not completely understood...
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Nature Publishing Group
2015
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| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4346614/ |
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pubmed-43466142015-03-13 Renal dysfunction in cirrhosis is not just a vasomotor nephropathy Adebayo, Danielle Morabito, Vincenzo Davenport, Andrew Jalan, Rajiv Mini Review The short-term mortality of cirrhotic patients who develop renal dysfunction remains unacceptably high, and as such the treatment of this condition is an unmet need. Although features of kidney injury are well recognized in these patients, the pathophysiology is complex and not completely understood. Improved understanding of the pathophysiological mechanisms involved in renal dysfunction occurring on a background of cirrhosis is key to developing effective treatment strategies to improve survival. Renal dysfunction due to hepatorenal syndrome (HRS) is characteristic of cirrhosis. Our current understanding is that HRS is functional in nature and occurs as a consequence of hemodynamic changes associated with portal hypertension. However, there is evidence in the literature suggesting that, histologically, the kidneys are not always normal in the vast majority of patients who present with renal dysfunction on the background of cirrhosis. Furthermore, there is emerging data implicating nonvasomotor mechanisms in the pathophysiology of renal dysfunction in cirrhosis. This mini-review aims to present the evidence suggesting that factors other than hemodynamic dysregulation have an important role in the development of this major complication for patients with progressive cirrhosis. Nature Publishing Group 2015-03 2014-10-08 /pmc/articles/PMC4346614/ /pubmed/25296092 http://dx.doi.org/10.1038/ki.2014.338 Text en Copyright © 2015 International Society of Nephrology http://creativecommons.org/licenses/by-nc-nd/3.0/ This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/3.0/ |
| repository_type |
Open Access Journal |
| institution_category |
Foreign Institution |
| institution |
US National Center for Biotechnology Information |
| building |
NCBI PubMed |
| collection |
Online Access |
| language |
English |
| format |
Online |
| author |
Adebayo, Danielle Morabito, Vincenzo Davenport, Andrew Jalan, Rajiv |
| spellingShingle |
Adebayo, Danielle Morabito, Vincenzo Davenport, Andrew Jalan, Rajiv Renal dysfunction in cirrhosis is not just a vasomotor nephropathy |
| author_facet |
Adebayo, Danielle Morabito, Vincenzo Davenport, Andrew Jalan, Rajiv |
| author_sort |
Adebayo, Danielle |
| title |
Renal dysfunction in cirrhosis is not just a vasomotor nephropathy |
| title_short |
Renal dysfunction in cirrhosis is not just a vasomotor nephropathy |
| title_full |
Renal dysfunction in cirrhosis is not just a vasomotor nephropathy |
| title_fullStr |
Renal dysfunction in cirrhosis is not just a vasomotor nephropathy |
| title_full_unstemmed |
Renal dysfunction in cirrhosis is not just a vasomotor nephropathy |
| title_sort |
renal dysfunction in cirrhosis is not just a vasomotor nephropathy |
| description |
The short-term mortality of cirrhotic patients who develop renal dysfunction remains unacceptably high, and as such the treatment of this condition is an unmet need. Although features of kidney injury are well recognized in these patients, the pathophysiology is complex and not completely understood. Improved understanding of the pathophysiological mechanisms involved in renal dysfunction occurring on a background of cirrhosis is key to developing effective treatment strategies to improve survival. Renal dysfunction due to hepatorenal syndrome (HRS) is characteristic of cirrhosis. Our current understanding is that HRS is functional in nature and occurs as a consequence of hemodynamic changes associated with portal hypertension. However, there is evidence in the literature suggesting that, histologically, the kidneys are not always normal in the vast majority of patients who present with renal dysfunction on the background of cirrhosis. Furthermore, there is emerging data implicating nonvasomotor mechanisms in the pathophysiology of renal dysfunction in cirrhosis. This mini-review aims to present the evidence suggesting that factors other than hemodynamic dysregulation have an important role in the development of this major complication for patients with progressive cirrhosis. |
| publisher |
Nature Publishing Group |
| publishDate |
2015 |
| url |
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4346614/ |
| _version_ |
1613194282094559232 |