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Working Party proposal for a revised classification system of renal dysfunction in patients with cirrhosis

ObjectivesTo propose an improvement on the current classification of renal dysfunction in cirrhosis. Clinicians caring for patients with cirrhosis recognize that the development of renal dysfunction is associated with significant morbidity and mortality. While most cases of renal dysfunction in cirr... Full description

Journal Title: Gut 2011-05, Vol.60 (5), p.702-709
Main Author: Wong, Florence
Other Authors: Nadim, Mitra K , Kellum, John A , Salerno, Francesco , Bellomo, Rinaldo , Gerbes, Alexander , Angeli, Paolo , Moreau, Richard , Davenport, Andrew , Jalan, Rajiv , Ronco, Claudio , Genyk, Yuri , Arroyo, Vicente
Format: Electronic Article Electronic Article
Language: English
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Publisher: London: BMJ Publishing Group Ltd and British Society of Gastroenterology
ID: ISSN: 0017-5749
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title: Working Party proposal for a revised classification system of renal dysfunction in patients with cirrhosis
format: Article
creator:
  • Wong, Florence
  • Nadim, Mitra K
  • Kellum, John A
  • Salerno, Francesco
  • Bellomo, Rinaldo
  • Gerbes, Alexander
  • Angeli, Paolo
  • Moreau, Richard
  • Davenport, Andrew
  • Jalan, Rajiv
  • Ronco, Claudio
  • Genyk, Yuri
  • Arroyo, Vicente
subjects:
  • Abridged Index Medicus
  • Acute kidney injury
  • Acute Kidney Injury - classification
  • Acute Kidney Injury - diagnosis
  • Acute Kidney Injury - etiology
  • Acute renal failure
  • Analysis
  • Analysis and chemistry
  • Biological and medical sciences
  • Biomedical Research - methods
  • Blood
  • chronic kidney disease
  • cirrhosis
  • Complications and side effects
  • creatinine
  • Diagnosis
  • Gangrene
  • Gastroenterology. Liver. Pancreas. Abdomen
  • hepatorenal syndrome
  • Hepatorenal Syndrome - diagnosis
  • Hepatorenal Syndrome - etiology
  • Hepatorenal Syndrome - physiopathology
  • Humans
  • Kidney diseases
  • Kidney Diseases - classification
  • Kidney Diseases - diagnosis
  • Kidney Diseases - etiology
  • Liver cirrhosis
  • Liver Cirrhosis - complications
  • Liver diseases
  • Liver. Biliary tract. Portal circulation. Exocrine pancreas
  • male genital diseases
  • Medical sciences
  • Medizin
  • Mortality
  • Other diseases. Semiology
  • Practice guidelines (Medicine)
  • renal dysfunction
  • Renal Insufficiency, Chronic - classification
  • Renal Insufficiency, Chronic - diagnosis
  • Renal Insufficiency, Chronic - etiology
  • Risk factors
  • Rodents
  • Terminology as Topic
  • Urine
  • urologic
  • Working groups
ispartof: Gut, 2011-05, Vol.60 (5), p.702-709
description: ObjectivesTo propose an improvement on the current classification of renal dysfunction in cirrhosis. Clinicians caring for patients with cirrhosis recognize that the development of renal dysfunction is associated with significant morbidity and mortality. While most cases of renal dysfunction in cirrhosis are functional in nature, developed as a result of changes in haemodynamics, cardiac function, and renal auto-regulation, there is an increasing number of patients with cirrhosis and structural changes in their kidney as a cause of renal dysfunction. Therefore, there is a need for a newer classification to include both functional and structural renal diseases.DesignA working party consisting of specialists from multiple disciplines conducted literature search and developed summary statements, incorporating the renal dysfunction classification used in nephrology. These were discussed and revised to produce this proposal.SettingMulti-disciplinary international meeting.PatientsNone.InterventionsLiterature search using keywords of cirrhosis, renal dysfunction, acute kidney injury (AKI), chronic kidney injury (CKD), and hepatorenal syndrome.ResultsAcute kidney injury will include all causes of acute deterioration of renal function as indicated by an increase in serum creatinine of >50% from baseline, or a rise in serum creatinine of ≥26.4µmol/L (≥0.3mg/dL) in
language: eng
source:
identifier: ISSN: 0017-5749
fulltext: no_fulltext
issn:
  • 0017-5749
  • 1468-3288
url: Link


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titleWorking Party proposal for a revised classification system of renal dysfunction in patients with cirrhosis
creatorWong, Florence ; Nadim, Mitra K ; Kellum, John A ; Salerno, Francesco ; Bellomo, Rinaldo ; Gerbes, Alexander ; Angeli, Paolo ; Moreau, Richard ; Davenport, Andrew ; Jalan, Rajiv ; Ronco, Claudio ; Genyk, Yuri ; Arroyo, Vicente
creatorcontribWong, Florence ; Nadim, Mitra K ; Kellum, John A ; Salerno, Francesco ; Bellomo, Rinaldo ; Gerbes, Alexander ; Angeli, Paolo ; Moreau, Richard ; Davenport, Andrew ; Jalan, Rajiv ; Ronco, Claudio ; Genyk, Yuri ; Arroyo, Vicente
descriptionObjectivesTo propose an improvement on the current classification of renal dysfunction in cirrhosis. Clinicians caring for patients with cirrhosis recognize that the development of renal dysfunction is associated with significant morbidity and mortality. While most cases of renal dysfunction in cirrhosis are functional in nature, developed as a result of changes in haemodynamics, cardiac function, and renal auto-regulation, there is an increasing number of patients with cirrhosis and structural changes in their kidney as a cause of renal dysfunction. Therefore, there is a need for a newer classification to include both functional and structural renal diseases.DesignA working party consisting of specialists from multiple disciplines conducted literature search and developed summary statements, incorporating the renal dysfunction classification used in nephrology. These were discussed and revised to produce this proposal.SettingMulti-disciplinary international meeting.PatientsNone.InterventionsLiterature search using keywords of cirrhosis, renal dysfunction, acute kidney injury (AKI), chronic kidney injury (CKD), and hepatorenal syndrome.ResultsAcute kidney injury will include all causes of acute deterioration of renal function as indicated by an increase in serum creatinine of >50% from baseline, or a rise in serum creatinine of ≥26.4µmol/L (≥0.3mg/dL) in <48hours. Chronic renal disease will be defined as an estimated glomerular filtration rate (GFR) of <60ml/min calculated using the Modification of Diet in Renal Disease 6 (MDRD6) formula, recognising that the MDRD6 formula is not perfect for the cirrhotic patients and this may change as improved means of estimating GFR becomes available. Acute on chronic kidney disease will be defined as AKI superimposed on existing chronic renal disease using the above definitions for AKI and CKD.ConclusionsAccepting this new classification will allow studies into the epidemiology, incidence, prevalence, natural history and the development of new treatments for these subtypes of renal dysfunction in cirrhosis.
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1EISSN: 1468-3288
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publisherLondon: BMJ Publishing Group Ltd and British Society of Gastroenterology
subjectAbridged Index Medicus ; Acute kidney injury ; Acute Kidney Injury - classification ; Acute Kidney Injury - diagnosis ; Acute Kidney Injury - etiology ; Acute renal failure ; Analysis ; Analysis and chemistry ; Biological and medical sciences ; Biomedical Research - methods ; Blood ; chronic kidney disease ; cirrhosis ; Complications and side effects ; creatinine ; Diagnosis ; Gangrene ; Gastroenterology. Liver. Pancreas. Abdomen ; hepatorenal syndrome ; Hepatorenal Syndrome - diagnosis ; Hepatorenal Syndrome - etiology ; Hepatorenal Syndrome - physiopathology ; Humans ; Kidney diseases ; Kidney Diseases - classification ; Kidney Diseases - diagnosis ; Kidney Diseases - etiology ; Liver cirrhosis ; Liver Cirrhosis - complications ; Liver diseases ; Liver. Biliary tract. Portal circulation. Exocrine pancreas ; male genital diseases ; Medical sciences ; Medizin ; Mortality ; Other diseases. Semiology ; Practice guidelines (Medicine) ; renal dysfunction ; Renal Insufficiency, Chronic - classification ; Renal Insufficiency, Chronic - diagnosis ; Renal Insufficiency, Chronic - etiology ; Risk factors ; Rodents ; Terminology as Topic ; Urine ; urologic ; Working groups
ispartofGut, 2011-05, Vol.60 (5), p.702-709
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1Nadim, Mitra K
2Kellum, John A
3Salerno, Francesco
4Bellomo, Rinaldo
5Gerbes, Alexander
6Angeli, Paolo
7Moreau, Richard
8Davenport, Andrew
9Jalan, Rajiv
10Ronco, Claudio
11Genyk, Yuri
12Arroyo, Vicente
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descriptionObjectivesTo propose an improvement on the current classification of renal dysfunction in cirrhosis. Clinicians caring for patients with cirrhosis recognize that the development of renal dysfunction is associated with significant morbidity and mortality. While most cases of renal dysfunction in cirrhosis are functional in nature, developed as a result of changes in haemodynamics, cardiac function, and renal auto-regulation, there is an increasing number of patients with cirrhosis and structural changes in their kidney as a cause of renal dysfunction. Therefore, there is a need for a newer classification to include both functional and structural renal diseases.DesignA working party consisting of specialists from multiple disciplines conducted literature search and developed summary statements, incorporating the renal dysfunction classification used in nephrology. These were discussed and revised to produce this proposal.SettingMulti-disciplinary international meeting.PatientsNone.InterventionsLiterature search using keywords of cirrhosis, renal dysfunction, acute kidney injury (AKI), chronic kidney injury (CKD), and hepatorenal syndrome.ResultsAcute kidney injury will include all causes of acute deterioration of renal function as indicated by an increase in serum creatinine of >50% from baseline, or a rise in serum creatinine of ≥26.4µmol/L (≥0.3mg/dL) in <48hours. Chronic renal disease will be defined as an estimated glomerular filtration rate (GFR) of <60ml/min calculated using the Modification of Diet in Renal Disease 6 (MDRD6) formula, recognising that the MDRD6 formula is not perfect for the cirrhotic patients and this may change as improved means of estimating GFR becomes available. Acute on chronic kidney disease will be defined as AKI superimposed on existing chronic renal disease using the above definitions for AKI and CKD.ConclusionsAccepting this new classification will allow studies into the epidemiology, incidence, prevalence, natural history and the development of new treatments for these subtypes of renal dysfunction in cirrhosis.
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0Abridged Index Medicus
1Acute kidney injury
2Acute Kidney Injury - classification
3Acute Kidney Injury - diagnosis
4Acute Kidney Injury - etiology
5Acute renal failure
6Analysis
7Analysis and chemistry
8Biological and medical sciences
9Biomedical Research - methods
10Blood
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12cirrhosis
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14creatinine
15Diagnosis
16Gangrene
17Gastroenterology. Liver. Pancreas. Abdomen
18hepatorenal syndrome
19Hepatorenal Syndrome - diagnosis
20Hepatorenal Syndrome - etiology
21Hepatorenal Syndrome - physiopathology
22Humans
23Kidney diseases
24Kidney Diseases - classification
25Kidney Diseases - diagnosis
26Kidney Diseases - etiology
27Liver cirrhosis
28Liver Cirrhosis - complications
29Liver diseases
30Liver. Biliary tract. Portal circulation. Exocrine pancreas
31male genital diseases
32Medical sciences
33Medizin
34Mortality
35Other diseases. Semiology
36Practice guidelines (Medicine)
37renal dysfunction
38Renal Insufficiency, Chronic - classification
39Renal Insufficiency, Chronic - diagnosis
40Renal Insufficiency, Chronic - etiology
41Risk factors
42Rodents
43Terminology as Topic
44Urine
45urologic
46Working groups
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9Jalan, Rajiv
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titleWorking Party proposal for a revised classification system of renal dysfunction in patients with cirrhosis
authorWong, Florence ; Nadim, Mitra K ; Kellum, John A ; Salerno, Francesco ; Bellomo, Rinaldo ; Gerbes, Alexander ; Angeli, Paolo ; Moreau, Richard ; Davenport, Andrew ; Jalan, Rajiv ; Ronco, Claudio ; Genyk, Yuri ; Arroyo, Vicente
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0Abridged Index Medicus
1Acute kidney injury
2Acute Kidney Injury - classification
3Acute Kidney Injury - diagnosis
4Acute Kidney Injury - etiology
5Acute renal failure
6Analysis
7Analysis and chemistry
8Biological and medical sciences
9Biomedical Research - methods
10Blood
11chronic kidney disease
12cirrhosis
13Complications and side effects
14creatinine
15Diagnosis
16Gangrene
17Gastroenterology. Liver. Pancreas. Abdomen
18hepatorenal syndrome
19Hepatorenal Syndrome - diagnosis
20Hepatorenal Syndrome - etiology
21Hepatorenal Syndrome - physiopathology
22Humans
23Kidney diseases
24Kidney Diseases - classification
25Kidney Diseases - diagnosis
26Kidney Diseases - etiology
27Liver cirrhosis
28Liver Cirrhosis - complications
29Liver diseases
30Liver. Biliary tract. Portal circulation. Exocrine pancreas
31male genital diseases
32Medical sciences
33Medizin
34Mortality
35Other diseases. Semiology
36Practice guidelines (Medicine)
37renal dysfunction
38Renal Insufficiency, Chronic - classification
39Renal Insufficiency, Chronic - diagnosis
40Renal Insufficiency, Chronic - etiology
41Risk factors
42Rodents
43Terminology as Topic
44Urine
45urologic
46Working groups
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1Nadim, Mitra K
2Kellum, John A
3Salerno, Francesco
4Bellomo, Rinaldo
5Gerbes, Alexander
6Angeli, Paolo
7Moreau, Richard
8Davenport, Andrew
9Jalan, Rajiv
10Ronco, Claudio
11Genyk, Yuri
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8Davenport, Andrew
9Jalan, Rajiv
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abstractObjectivesTo propose an improvement on the current classification of renal dysfunction in cirrhosis. Clinicians caring for patients with cirrhosis recognize that the development of renal dysfunction is associated with significant morbidity and mortality. While most cases of renal dysfunction in cirrhosis are functional in nature, developed as a result of changes in haemodynamics, cardiac function, and renal auto-regulation, there is an increasing number of patients with cirrhosis and structural changes in their kidney as a cause of renal dysfunction. Therefore, there is a need for a newer classification to include both functional and structural renal diseases.DesignA working party consisting of specialists from multiple disciplines conducted literature search and developed summary statements, incorporating the renal dysfunction classification used in nephrology. These were discussed and revised to produce this proposal.SettingMulti-disciplinary international meeting.PatientsNone.InterventionsLiterature search using keywords of cirrhosis, renal dysfunction, acute kidney injury (AKI), chronic kidney injury (CKD), and hepatorenal syndrome.ResultsAcute kidney injury will include all causes of acute deterioration of renal function as indicated by an increase in serum creatinine of >50% from baseline, or a rise in serum creatinine of ≥26.4µmol/L (≥0.3mg/dL) in <48hours. Chronic renal disease will be defined as an estimated glomerular filtration rate (GFR) of <60ml/min calculated using the Modification of Diet in Renal Disease 6 (MDRD6) formula, recognising that the MDRD6 formula is not perfect for the cirrhotic patients and this may change as improved means of estimating GFR becomes available. Acute on chronic kidney disease will be defined as AKI superimposed on existing chronic renal disease using the above definitions for AKI and CKD.ConclusionsAccepting this new classification will allow studies into the epidemiology, incidence, prevalence, natural history and the development of new treatments for these subtypes of renal dysfunction in cirrhosis.
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pmid21325171
doi10.1136/gut.2010.236133
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