Renal dysfunction in patients with cirrhosis: Where do we stand?

Table 4 Recomendations for renal function evaluation in subgroups of patients with cirrhosis

Differentiate prerenal kidney disease, hepatorenal syndrome and acute tubular necrosis	Angeli et al[5] algorithm
Acute kidney injury	Modified cirrhosis–acute kidney injury classification sCr increase ≥ 0.3 mg/dL (≥ 26.4 μmol/L) or more than 150% (1.5 fold from baseline) within 48 h from the first measurement[12]
Chronic kidney disease	KDOQI[49] guidelines Glomerular filtration rate below 60 mL/min for more than three months, calculated using the modified diet in renal disease-6 formula chronic kidney disease epidemiology collaboration Cys C-Cr equation[51]
Critically ill cirrhotic patients	RIFLE score[18,19] MBRS score[61,62] combining mean arterial pressure, bilirubin, respiratory failure and sepsis
Candidates for liver transplantation	Exogenous filtration markers If there is suspicion for parenchymal disease and Glomerular filtration rate is between 30-60 mL/min consider renal biopsy
Advanced cirrhosis	Cystatin C
Difficulties in differentiation of acute tubular necrosis	NGAL
All patients with cirrhosis in every stage of liver disease	Renal resistive index estimation by renal duplex doppler ultrasound

KDOQI: Kidney disease outcomes quality initiative.