Kidneys in chronic liver diseases

Table 1 Causes of renal failure in chronic liver disease

Acute	Chronic
Hypovolemia (diuretics, hemorrhage, diarrhoea)	Hepatorenal syndrome - type 2
Hepatorenal syndrome - type 1	Glomerulonephritis (HCV infection)
Acute tubular necrosis	Glomerulonephritis (HBV infection)
Nephrotoxic agents (NSAIDs, aminoglycosides, radiological contrasts)	Immunoglobulin A nephropathy1
Sepsis	Diabetic nephropathy2

¹Mainly in alcoholic cirrhosis;

²Mainly combined with non-alcoholic steatohepatitis. NSAIDs: Non-steroidal anti-inflammatory drugs; HBV: Hepatitis B virus; HCV: Hepatitis C virus.

Table 2 Clinical conditions leading to concomitant liver and renal injury

Drug-induced hepato-nephrotoxicity (acetaminophen, aspirin, NSAIDs)

Granulomatous diseases (e.g., sarcoidosis, leptospirosis)

Storage diseases (e.g., amyloidosis)

Systemic autoimmune diseases (e.g., lupus erythematosus)

Non-alcoholic fatty liver disease and diabetic nephropathy

Autosomal dominant polycystic kidney disease

Wilson’s disease

Pregnancy-induced liver diseases (pre-eclampsia /HELLP syndrome)

Shock (cardiac failure, sepsis, hemorrhage, dehydration)

Alpha1-antitrypsin deficiency

NSAIDs: Non-steroidal anti-inflammatory drugs; HELLP: Hemolysis, elevated liver enzymes, low platelet count.