Chronic renal dysfunction in cirrhosis: A new frontier in hepatology

Figure 1 Risk factors associated with chronic kidney disease in patients with liver cirrhosis. A rising trend in the prevalence of medicine degree, hypertension and non-alcoholic fatty liver disease seem to be the key factors behind the increased prevalence of chronic kidney disease in cirrhosis. The risk of developing de-novo chronic kidney disease remains high for acute kidney injury survivors. CKD: Chronic kidney disease; HTN: Hypertension; HBV: Hepatis B virus; HCV: Hepatitis C virus; RAAS: Renin-angiotensin-aldosterone system; SNS: Sympathetic nervous system; AVP: Arginine vasopressin; GI: Gastrointestinal; NAFLD: Non-alcoholic fatty liver disease; HRS: Hepatorenal syndrome; AKI: Acute kidney injury.

Figure 2 Ultrasonographic image of a 65-year-old diabetic patient with liver cirrhosis and chronic kidney disease. A: The liver outline is irregular (white arrows) and there is ascites around it. The right kidney is small and the parenchymal echogenicity is increased with loss of corticomedullary differentiation (asterisk), suggesting chronic kidney disease; B: Doppler sonogram of the same kidney showed reversal of diastolic flow (orange arrow) with absent end-diastolic velocity, indicating very high resistance vessels.