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Management of Renal Failure

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Chronic Liver Failure

Part of the book series: Clinical Gastroenterology ((CG))

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Abstract

Renal failure is a common complication of cirrhosis with ascites. The most frequent type of renal failure in cirrhosis is that induced by diuretics. Ascites reabsorption is a rate-limited phenomenon and if diuretics increase urine volume at a rate greater than the passage of ascites from the peritoneal cavity to the systemic circulation, a contraction of the effective plasma volume occurs leading to renal hypoperfusion and reduction in GFR (1). Diuretic-induced renal failure is rapidly reversible after discontinuation of therapy and usually does not progress to more severe types of renal failure, such as hepatorenal syndrome (HRS) or acute tubular necrosis (ATN). Acute bacterial infection is also frequently associated with renal failure (2, 3), and usually reverses after infection resolves. However, renal failure associated with infections may progress to HRS.

Supported in part by grants from Fondo de Investigación Sanitaria FIS070443 and 080108. Centro de investigaciones en red de enfermedades hepaticas y digestivas (CIBEREHD) is supported by the Instituto de Salud Carlos III.

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Authors and Affiliations

  1. Liver Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain

    Vicente Arroyo MD

  2. Liver Unit, Institut of Digestive and Metabolic Disease, IDIBAPS. Ciberehd, Hospital Clinic, University of Barcelona, Barcelona, Spain

    Mónica Guevara MD

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  1. Vicente Arroyo MD
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  2. Mónica Guevara MD
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Editors and Affiliations

  1. Liver Unit, Hospital Clinic, University of Barcelona, Villarroel 170, Barcelona, 08036, Spain

    Pere Ginès

  2. College of Medicine, Division of Gastroenterology and Hepatol, Mayo Clinic, 200 First St. S.W, Rochester, 55905, Minnesota, USA

    Patrick S. Kamath

  3. Liver Unit, Hospital Clinic, University of Barcelona, Barcelona, 08036, Spain

    Vicente Arroyo

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Arroyo, V., Guevara, M. (2011). Management of Renal Failure. In: Ginès, P., Kamath, P., Arroyo, V. (eds) Chronic Liver Failure. Clinical Gastroenterology. Humana Press. https://doi.org/10.1007/978-1-60761-866-9_22

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  • DOI: https://doi.org/10.1007/978-1-60761-866-9_22

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