The Liver Meeting 2019-Case Directed Discussion: ACLF Due to AKI/HRS

Video Transcription

Video Summary

The video transcript discusses a case of a 52-year-old female with decompensated cirrhosis, secondary to NASH, and active alcohol use presenting with abdominal pain, fever, and confusion. The patient has liver complications including ascites and variceal bleed, along with type 2 diabetes and multiple medications. The discussion includes considerations for acute kidney injury, sarcopenia, and the use of vasoconstrictors. The importance of assessing urinary biomarkers, including urinary sodium and FINA, is highlighted in differentiating between hepatorenal syndrome and acute tubular necrosis. The decision-making process for initiating renal support therapy, such as CRRT, and the criteria for considering a liver kidney transplant in cases of severe AKI are also explored. The panel emphasizes individualized patient care and the need for interdisciplinary collaboration in managing complex cases.

Asset Caption

Presenter: Puneeta Tandon

Keywords

decompensated cirrhosis

NASH

alcohol use

ascites

variceal bleed

hepatorenal syndrome

acute tubular necrosis