Interest of the Echocardiography in the Management of Cirrhotic Patients With Acute Kidney Injury
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This prospective study focuses on the interest of the echocardiography for cirrhotic patients, who present acute kidney injury corresponding to the criteria of hepatorenal syndrome. This echocardiography will be done before the volemic expansion and the final diagnostic of hepatorenal syndrome or prerenal azotemia. The primary endpoint is to describe the hemodynamic characteristics of this population at the time of acute kidney injury and their association with diagnostic of hepatorenal syndrome or prerenal azotemia. Patients with elevated filling pressure, predicting poor outcome of volemic expansion will be excluded of the study after the echocardiography and will not undergo volemic expansion but appropriate management.
Condition or disease
CirrhosisHepatorenal SyndromeAcute Kidney InjuryDiastolic Function
Hemodynamic features assessed by echocardiography before the volemic expansion of cirrhotic patients with acute renal injury corresponding to the criteria of hepatorenal syndrome. [ Time Frame: At Day0 : at the time of diagnostic of acute kidney injury, before volemic expansion. ]
Systolic and diastolic function assessment, filling pressures, pulmonary arterial hypertension
Secondary Outcome Measures :
Tolerance of volemic expansion, as recommended by international guidelines [ Time Frame: After 48 hours of volemic expansion ]
Clinical tolerance of volemic expansion, acute pulmonary oedema
Response to vasoconstrictor treatment of hepatorenal syndrome, in case of diagnostic of hepatorenal syndrome [ Time Frame: 1 month after inclusion ]
Renal function recovery, renal replacement therapy, liver transplantation
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Layout table for eligibility information
Ages Eligible for Study:
18 Years and older (Adult, Older Adult)
Sexes Eligible for Study:
Accepts Healthy Volunteers:
patients > 18 years
written consent for the participation of the study
cirrhosis with portal hypertension and ascite
acute kidney injury according to AKIN criteria (rapid increase of creatinine (48 hours) > 26.4 µmol or > 50% comparing with baseline). Baseline creatinine is the last value of creatinine before admission or creatinine at the admission if stable during 5 days.
absence of argument for acute tubular necrosis or other organic acute renal injury