ReviewNature reviews. Nephrology2020
Reappraising the spectrum of AKI and hepatorenal syndrome in patients with cirrhosis.
Review in Nature reviews. Nephrology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 51 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
51 citing papers in PubMed, 3 syntheses or guidelines pooled it, 125 citations in OpenAlex.
- Association of non-selective β blockers with the development of renal dysfunction in liver cirrhosis: a systematic review and meta-analysis.Annals of medicine · 2024Pooled it
- Chinese guidelines on the management of ascites in cirrhosis : Chinese Society of Hepatology, Chinese Medical Association.Hepatology international · 2024Guideline
- [Guidelines on the management of ascites in cirrhosis (2023 version)].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2023Guideline
- The creatinine-to-albumin ratio as a prognostic indicator in critically ill patients with cirrhosis: A cohort study.Medicine · 2026Article
- Point-of-Care Ultrasound Assessment of Pulmonary and Venous Congestion in Patients with Liver Cirrhosis and Acute Kidney Injury Receiving Albumin: An Exploratory Prospective Study from a Resource-Limited Tertiary Care Center in Western Mexico.Medicina (Kaunas, Lithuania) · 2026Article
- Machine learning outperforms serum creatinine for early risk stratification of hepatorenal syndrome: a prospective single-center validation.Hepatology international · 2026Article
- The Kidney in the Shadow of Cirrhosis: A Critical Review of Renal Failure.Biomedicines · 2025Review
- Enteronephrohepatic circulation of bile acids and therapeutic potential of systemic bile acid transporter inhibitors.Journal of hepatology · 2025Review
- Benefits and challenges to therapeutic targeting of bile acid circulation in cholestatic liver disease.Hepatology (Baltimore, Md.) · 2025Review
- Acute versus acute-on-chronic liver failure: comparative analysis of clinical outcomes in Beijing, China.BMC gastroenterology · 2025Article
- Acute Kidney Injury in Patients with Liver Cirrhosis: From Past to Present Definition and Diagnosis.Life (Basel, Switzerland) · 2025Review
- Novel multifunctional targeted nanozyme as an ultrasound contrast agent for real-time monitoring and treatment of congenital hydronephrosis renal fibrosis.Journal of nanobiotechnology · 2025Article
- A novel risk-predicted nomogram for acute kidney injury progression in decompensated cirrhosis: a double-center study in Vietnam.International urology and nephrology · 2025Article
- Liver-Kidney Crosstalk in Major Pediatric Diseases: Unraveling the Complexities and Clinical Challenges.Journal of clinical medicine · 2025Review
- Hepatorenal syndrome: Paving a pathway from a fatal condition to an opportunity to preserve kidney function.World journal of nephrology · 2025Article
- Transition from acute kidney injury to chronic kidney disease in liver cirrhosis patients: Current perspective.World journal of nephrology · 2025Review
- Management of the acute on chronic liver failure in the intensive care unit.Liver international : official journal of the International Association for the Study of the Liver · 2025Review
- Addition of a Loop Diuretic to Norepinephrine During Treatment of Hepatorenal Syndrome Type 1.Kidney international reports · 2025Article
- Point-of-care ultrasonography in cirrhosis-related acute kidney injury: How I do it.World journal of critical care medicine · 2024Review
- Long-Circulating Vasoactive 1,18-Octadecanedioic Acid-Terlipressin Conjugate.ACS pharmacology & translational science · 2024Article
Corrections and comments
- Erratum issued
Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The occurrence of acute kidney injury (AKI) in patients with end-stage liver disease constitutes one of the most challenging clinical scenarios in in-hospital and critical care medicine. Hepatorenal syndrome type 1 (HRS-1), which is a specific type of AKI that occurs in the context of advanced cirrhosis and portal hypertension, is associated with particularly high mortality. The pathogenesis of HRS-1 is largely viewed as a functional derangement that ultimately affects renal vasculature tone. However, new insights suggest that non-haemodynamic tubulo-toxic factors, such as endotoxins and bile acids, might mediate parenchymal renal injury in patients with cirrhosis, suggesting that concurrent mechanisms, including those traditionally associated with HRS-1 and non-traditional factors, might contribute to the development of AKI in patients with cirrhosis. Moreover, histological evidence of morphological abnormalities in the kidneys of patients with cirrhosis and renal dysfunction has prompted the functional nature of HRS-1 to be re-examined. From a clinical perspective, a diagnosis of HRS-1 guides utilization of vasoconstrictive therapy and decisions regarding renal replacement therapy. Patients with cirrhosis are at risk of AKI owing to a wide range of factors. However, the tools currently available to ascertain the diagnosis of HRS-1 and guide therapy are suboptimal. Short of liver transplantation, goal-directed haemodynamically targeted pharmacotherapy remains the cornerstone of treatment for this condition; improved understanding of the underlying pathogenic mechanisms might lead to better clinical outcomes. Here, we examine our current understanding of the pathophysiology of HRS-1 and existing challenges in its diagnosis and treatment.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.