TY  - CHAP
M1  - Book, Section
TI  - Renal Function and Liver Transplantation
A1  - Reimundes, Ezequiel Rodríguez
A2  - Molmenti, Ernesto Pompeo
A2  - Santibañes, Martin de
A2  - Santibañes, Eduardo de
PY  - 2021
T2  - Liver Transplantation: Operative Techniques and Medical Management
AB  - Kidney  dysfunction  is  very  frequent  in  patients  with  advanced  liver  disease  and/or  portal  hypertension  and  is  independently  associated  with  decreased  survival.1,2Kidney  dysfunction  may  be  acute,  chronic,  and  acute-on-chronic.  A  major  difficulty  in  general  medical  and  surgical  settings  is  to  determine  the  real  baseline  renal  function.Kidney  dysfunction  may  be  due  to  structural  damage,  to  hemodynamic  alterations  related  to  portal  hypertension,  or  to  both.Recognition  of  renal  dysfunction  in  patients  with  liver  disease  and  understanding  the  pathophysiologic  mechanism  is  essential  because:Renal  dysfunction  is  associated  with  poor  outcomes.Reversible  causes  of  renal  dysfunction  can  be  identified  and  treated.Renal  dysfunction  may  be  the  first  marker  of  a  multiorgan  dysfunction,  as  in  sepsis  and  cardiocirculatory  hepatorenal  disease.Renal  function  is  usually  assessed  by  measurement  of  serum  creatinine.  Nevertheless,  serum  creatinine  is  an  inaccurate  marker  of  glomerular  filtration  rate  (GFR)  in  the  setting  of  advanced  liver  disease  and/or  portal  hypertension.Accurate  quantitative  assessment  of  renal  function  is  not  easy,  may  be  cumbersome,  and  most  of  the  time  is  not  strictly  necessary.However,  accurate  assessment  of  renal  function  may  be  crucial  to:Identify  patients  whose  renal  function  is  expected  to  improve  after  transplantation.Recognize  patients  necessitating  a  simultaneous  kidney  and  liver  transplantation.Assure  an  equitable  allocation  of  organs  for  transplantation.  
SN  - 
PB  - McGraw Hill
CY  - New York, NY
Y2  - 2024/04/18
UR  - accesssurgery.mhmedical.com/content.aspx?aid=1180108507
ER  -