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To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

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Kidney Week

Educational Symposium

Current and Future Approaches to the Diagnostic Assessment and Management of AKI in Patients with Cirrhosis

November 04, 2022 | 12:45 PM - 01:45 PM

Location: Regency Ballroom R, Hyatt Regency Orlando

Session Description

AKI in patients with cirrhosis is diagnosed and staged using the KDIGO classification system. The differential diagnosis of AKI in patients with cirrhosis is broadly similar to other patient populations (prerenal, intrarenal, and postrenal causes) but also includes a functional cause that is specific to patients with cirrhosis: hepatorenal syndrome type 1 (now termed HRS-AKI), which has poor outcomes.

Management of HRS-AKI typically involves diuretic withdrawal and volume expansion with IV albumin infusions. In some cases that are refractory to volume expansion, IV vasoconstrictor therapy is given, with some evidence that this approach can improve kidney function in some patients with HRS-AKI. However, clinical outcomes are not consistently improved with this approach, and adverse events associated with volume overload and tissue ischemia have been reported.

This symposium reviews the current evidence supporting the recommended diagnostic approach to AKI in patients with cirrhosis and the management of HRS-AKI specifically and considers how improvements to the standard of care might be achieved.

Support is provided by an educational grant from Mallinckrodt Pharmaceuticals.

Learning Objective(s)

  • Describe the current diagnostic approach to AKI in patients with cirrhosis
  • Examine the pros and cons of current therapies for HRS with AKI
  • Discuss how better diagnostics and targeted therapeutics might improve care

Learning Pathway(s)

  • AKI and Critical Care


  • Kathleen D. Liu, MD, PhD, FASN


  • Introduction
    12:45 PM - 12:55 PM
    Kathleen D. Liu, MD, PhD, FASN
  • Current Approach to the Diagnostic Evaluation of Patients with AKI and Cirrhosis
    12:55 PM - 01:15 PM
    Chirag R. Parikh, MD, PhD, FASN
  • Evidence-Based Management of Hepatorenal Syndrome with AKI
    01:15 PM - 01:35 PM
    Florence Wong, MD
  • Questions and Answers
    01:35 PM - 01:45 PM