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Volume 15
Issue 8
10.3390/life15081249
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Review

Acute Kidney Injury in Patients with Liver Cirrhosis: From Past to Present Definition and Diagnosis

by
Andreea Lungu
1,2,
Georgiana-Elena Sarbu
1,2,
Alexandru Sebastian Cotlet
2,
Ilie-Andreas Savin
1,2,
Ioana-Roxana Damian
1,2,
Simona Juncu
1,2,*,
Cristina Muzica
1,2,*,
Irina Girleanu
1,2,
Ana-Maria Sîngeap
1,2,
Carol Stanciu
1,2,
Anca Trifan
1,2 and
Camelia Cojocariu
1,2
1
Department of Gastroenterology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Universitatii Street No. 16, 700115 Iasi, Romania
2
Institute of Gastroenterology and Hepatology, “St. Spiridon” Emergency County Hospital, Bd. Independentei No. 1, 700111 Iasi, Romania
*
Authors to whom correspondence should be addressed.
Life 2025, 15(8), 1249; https://doi.org/10.3390/life15081249
Submission received: 5 July 2025 / Revised: 29 July 2025 / Accepted: 5 August 2025 / Published: 6 August 2025
(This article belongs to the Special Issue Acute Kidney Events in Intensive Care)
Versions Notes

Abstract

Acute kidney injury (AKI) is a serious clinical condition that is linked to markedly higher rates of morbidity and mortality in cirrhosis patients. Its diagnosis is challenging due to overlapping clinical and laboratory features among causes such as hepatorenal syndrome (HRS), acute tubular injury (ATI), and prerenal hypovolemia. In order to address the distinct pathophysiology and clinical context of cirrhosis, the definitions and classification of AKI have changed over time, moving from RIFLE and AKIN to KDIGO and ICA-AKI. Because cirrhosis patients have altered muscle mass and fluid retention, traditional markers like serum creatinine (sCr) and urine output have significant limitations. Neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), interleukin-18 (IL-18), and cystatin C (CysC) are some of the new biomarkers that have shown promise in early AKI detection and in differentiating structural from functional kidney injury. NGAL and KIM-1 are sensitive indicators of tubular damage with potential prognostic implications. IL-18 reflects inflammatory injury, and CysC offers a more reliable measure of glomerular filtration. Incorporating these markers may improve early diagnosis, risk stratification, and treatment decisions, representing a key direction for future research in managing AKI in cirrhosis.
Keywords: biomarkers; acute kidney disease; acute kidney injury biomarkers; acute kidney disease; acute kidney injury

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MDPI and ACS Style

Lungu, A.; Sarbu, G.-E.; Cotlet, A.S.; Savin, I.-A.; Damian, I.-R.; Juncu, S.; Muzica, C.; Girleanu, I.; Sîngeap, A.-M.; Stanciu, C.; et al. Acute Kidney Injury in Patients with Liver Cirrhosis: From Past to Present Definition and Diagnosis. Life 2025, 15, 1249. https://doi.org/10.3390/life15081249

AMA Style

Lungu A, Sarbu G-E, Cotlet AS, Savin I-A, Damian I-R, Juncu S, Muzica C, Girleanu I, Sîngeap A-M, Stanciu C, et al. Acute Kidney Injury in Patients with Liver Cirrhosis: From Past to Present Definition and Diagnosis. Life. 2025; 15(8):1249. https://doi.org/10.3390/life15081249

Chicago/Turabian Style

Lungu, Andreea, Georgiana-Elena Sarbu, Alexandru Sebastian Cotlet, Ilie-Andreas Savin, Ioana-Roxana Damian, Simona Juncu, Cristina Muzica, Irina Girleanu, Ana-Maria Sîngeap, Carol Stanciu, and et al. 2025. "Acute Kidney Injury in Patients with Liver Cirrhosis: From Past to Present Definition and Diagnosis" Life 15, no. 8: 1249. https://doi.org/10.3390/life15081249

APA Style

Lungu, A., Sarbu, G.-E., Cotlet, A. S., Savin, I.-A., Damian, I.-R., Juncu, S., Muzica, C., Girleanu, I., Sîngeap, A.-M., Stanciu, C., Trifan, A., & Cojocariu, C. (2025). Acute Kidney Injury in Patients with Liver Cirrhosis: From Past to Present Definition and Diagnosis. Life, 15(8), 1249. https://doi.org/10.3390/life15081249

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