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ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

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Kidney Week

Educational Symposium

Hepatorenal Syndrome Type 1: Advances in Management

November 05, 2021 | 12:45 PM - 01:45 PM

Location: Simulive, Virtual Only

Session Description

Patients with cirrhosis are very susceptible to AKI. This is because of the hemodynamic derangements present during advanced cirrhosis (hepatorenal physiology) and the frequent exposure to a variety of potentially nephrotoxic factors, including endotoxemia, endogenous metabolites, cholephiles, and medications. Hepatorenal syndrome (HRS) is a specific form of AKI predominantly caused by systemic hemodynamic derangements, together with renal vasoconstriction. Because systemic mesenteric vasodilation is a key factor in initiating HRS, vasoconstrictors together with albumin are the basis of treatment. However, recent trials have found that volume overload impedes optimal use of this therapy.

This symposium describes how to assess changing volume status in patients with cirrhosis to minimize the development of complications from volume overload. Experts then review the trials using vasoconstrictors and propose potential best practices for maximizing their benefit and reducing adverse effects.

Support is provided by an educational grant from Mallinckrodt Pharmaceuticals.

Learning Objective(s)

  • Describe how to assess and manage volume status in patients with cirrhosis, including how to anticipate changes based on different therapeutic interventions
  • Discuss the use of vasoconstrictors in cirrhosis-associated AKI

Learning Pathway(s)

  • Acute Kidney Injury


  • Mitra K. Nadim, MD, FASN


  • Introduction
    12:45 PM - 12:55 PM
    Mitra K. Nadim, MD, FASN
  • Volume Management in Cirrhosis-Associated AKI: Avoiding Iatrogenic Volume Overload
    12:55 PM - 01:20 PM
    Nithin Karakala, MD, FASN
  • Comparison of Vasoconstrictors in Cirrhosis-Associated AKI
    01:20 PM - 01:45 PM
    Kevin R. Regner, MD, MS, FASN