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The impact of acute kidney injury in cirrhosis: does definition matter?
  1. Cynthia Tsien,
  2. Florence Wong
  1. Department of Medicine, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Florence Wong, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada M5G 2C4; florence.wong{at}utoronto.ca

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The definition of renal dysfunction in cirrhosis is undergoing some changes in recent times.1 Although the definition of hepatorenal syndrome2 has served the hepatology community very well by identifying patients with cirrhosis, who are severely ill with advanced kidney failure in the presence of liver failure, many of these patients are so ill that they are no longer responsive to our currently available therapies for hepatorenal syndrome. Therefore, it was proposed that the definition of renal dysfunction in cirrhosis should be modified adapting to the guidelines proposed by the acute kidney injury (AKI) network.3 The proposed definition allows for a diagnosis of AKI whenever there is either a rise in serum creatinine by 0.3 mg/dl in <48 h or a rise by 50% from baseline. Using this new definition, many patients …

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