Several issues regarding evaluation of renal injury and renal insufficiency in patients with liver disease

In patients with liver disease such as viral hepatitis and liver cirrhosis,renal injury and renal insufficiency can be generally classified as acute kidney injury( AKI),chronic kidney disease,and acute- on- chronic nephropathy. AKI can be classified as stage 1( risk stage),stage 2( injury stage),and stage 3( failure stage). Traditionally hepatorenal syndrome is classified as types Ⅰ and Ⅱ,and in recent years,type Ⅲ hepatorenal syndrome with organic renal injury has been proposed. Hepatorenal disorder( HRD) is used to describe any renal disease which occurs in patients with liver cirrhosis. At present,sensitive and accurate biochemical parameters used to evaluate renal function in patients with liver disease in clinical practice include estimated glomerular filtration rate,increase in serum creatinine within unit time,and serum cystatin C level,and urinary microalbumin level also plays an important role in the early diagnosis of nephropathy. Causes of liver disease,severity,complications including infection,nutritional status,therapeutic drugs,and underlying nephropathy may be associated with renal injury and renal insufficiency in patients with liver disease and should be differentiated.