Welcome to our new four-episode series: Raising Awareness of Hepatorenal Syndrome Acute Kidney Injury. This podcast program is in conjunction with four journal articles published in AGA’s Clinical Gastroenterology and Hepatology (CGH), which are dedicated to addressing knowledge gaps in hepatorenal syndrome acute kidney injury (HRS-AKI) including how to diagnose, new diagnostic tools and emerging treatment options.

  Click for articles 

The series, hosted by Muhamad Nadeem Yousaf, MD, examines key information selected from the journal articles, focusing on adopting a patient-centered approach to understand the pathogenesis, diagnosis and emerging treatment options of HRS-AKI, while also delving into best practices for transitions of care. 

Learning objectives:

After completing all four episodes in this series, learners will be able to: 

• Distinguish HRS-AKI from other kidney disorders with overlapping symptoms.
• Evaluate the use of current and emerging pharmacological and non-pharmacological therapies of HRS-AKI.
• Understand the role of liver and kidney transplant in the treatment of HRS-AKI and the organ waitlist prioritization criteria.

Episode 1. Hepatorenal syndrome–acute kidney injury: Pathophysiology

In this episode, Dr. Yousaf and co-authors, Danielle Adebayo, MD, and Florence Wong, MD, MBBS, FRCPC, analyze the peripheral vasodilatation hypothesis shortcomings in HRS-AKI, emphasize vasoconstrictor systems, bacterial translocation, inflammation, renal dysfunction, and contributory factors like cholemic nephropathy and adrenal insufficiency, while also suggesting the potential of metabolomic studies for future insights. 

Host:

Muhamad Nadeem Yousaf, MD
Gastroenterology fellow
University of Missouri-Columbia
AGA Young Delegate

Guest Speakers:

Danielle Adebayo, MD
Gastroenterologist/hepatologist
The Royal Berkshire Hospital NHS Trust United Kingdom

Florence Wong, MD, MBBS, FRCPC
Professor of medicine,
The University of Toronto
Staff hepatologist, Toronto General Hospital, Ontario, Canada

Episode 2. Hepatorenal syndrome–acute kidney injury: Current pharmacologic

In this episode, Dr. Yousaf and Nikki Duong, MD, co-author of the journal article on current pharmacologic therapies for HRS-AKI, discuss the nomenclature, pharmacological options and care recommendations for HRS-AKI patients. 

Host:

Muhamad Nadeem Yousaf, MD
Gastroenterology fellow
University of Missouri-Columbia
AGA Young Delegate

Guest Speaker:

Nikki Duong, MD
Clinical assistant professor of medicine
Stanford University Medical Center

Episode 3. Hepatorenal syndrome–acute kidney injury: Diagnosis and non-pharmacological management

In this episode, Dr. Yousaf, joined by co-authors Nik Mazumder, MD, MPH,  Shilpa Junna, MD, and Pratima Sharma, MD, MBBS, MS, delves into the initial management of patients with HRS-AKI, exploring topics such as the efficacy of non-selective beta-blockers, the recommended plasma expander for those with decompensated cirrhosis, the roles of renal replacement therapy (RRT), TIPS, and extracorporeal liver support system (ELSS), and the significance of liver transplant in the context of HRS-AKI. 

Host:

Muhamad Nadeem Yousaf, MD
Gastroenterology fellow
University of Missouri-Columbia
AGA Young Delegate

Guest Speakers:

Nik Mazumder, MD, MPH
Clinical instructor
Division of gastroenterology and hepatology, University of Michigan, Ann Arbor

Shilpa Junna, MD
Assistant professor
Division of gastroenterology and hepatology, Cleveland Clinic

Pratima Sharma, MD, MBBS, MS
Associate professor
Division of gastroenterology and hepatology, University of Michigan, Ann Arbor

Episode 4. Hepatorenal syndrome–acute kidney injury: Liver transplantation

In this episode, Dr. Yousaf, joined by Vivian Ortiz, MD, and Neil Shah, MD, delve into critical aspects of hepatorenal syndrome, discussing the prognosis after initial management, the significance of reversing renal impairment for liver transplant candidates, the predictive role of the model for end-stage liver disease (MELD) score in HRS-AKI, treatment's impact on liver transplant waiting lists, decision-making between liver transplant alone or simultaneous liver-kidney transplant, timing considerations for kidney transplant post-liver transplant, and factors affecting post-transplant prognosis. 

Host:

Muhamad Nadeem Yousaf, MD
Gastroenterology fellow
University of Missouri-Columbia
AGA Young Delegate

Guest Speakers:

Vivian Ortiz, MD
Assistant professor of medicine and transplant hepatologist
Washington University St. Louis

Neil Shah, MD
Assistant professor of medicine and associate fellowship program director
Division of gastroenterology and hepatology, University of North Carolina School of Medicine

Sponsorship:

This series is supported by an independent educational grant from Mallinckrodt.