Advances In™ Cirrhosis: Reframing the Management of Hepatorenal Syndrome-Acute Kidney Injury: A Review of Current Strategies

Released On
June 28, 2022

Expires On
June 28, 2023

Media Type

Completion Time
60 minutes

Hepatology, Gastroenterology, Nephrology, Physician Care

HRS-AKI, Cirrhosis

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This activity is provided by Physicians’ Education Resource®, LLC.


This activity is supported by an educational grant from Mallinckrodt Pharmaceuticals.

Credit Available

  • Physicians — maximum of 1.0 AMA PRA Category 1 Credit(s)
  • Nurses — 1.0 Contact Hours

All other healthcare professionals completing this course will be issued a statement of participation.

Target Audience

This educational activity is directed toward health care providers treating patients with cirrhosis, including hepatologists, gastroenterologists, nephrologists, critical care specialists, physician assistants, and nurses. Other health care professionals also will be invited to participate.

Program Overview

HRS is the deadliest complication of cirrhosis. HRS-AKI, the extreme form of kidney injury in patients, is caused by a reduction in renal blood flow unresponsive to volume expansion. The literature surrounding HRS-AKI is rapidly evolving, and newer tests and updated definitions have been proposed, facilitating more timely identification and treatment of HRS. The number of patients with advanced liver disease in the United States is increasing; therefore, clinicians should be both aware of the risk of HRS-AKI in patients with cirrhosis and familiar with the guidelines on diagnosis and management.

In this program, Dr Elizabeth Verna and Dr Lisa B. VanWagner outline strategies for diagnosing and treating HRS-AKI patients and take an objective look at pharmacologic treatment, updated pathophysiology, and realistic goals of HRS-AKI treatment with a focus on slowing the progression of disease and consideration of treatment complications.

Learning Objectives

Upon completion of this activity, participants should be better able to:

  • Describe recommended diagnostic practices for patients with HRS-AKI
  • Identify HRS-AKI as a unique disease with high morbidity and mortality
  • Identify reasons behind updated diagnostic criteria
  • Recognize the complex pathology of HRS-AKI and emerging approaches intended to intervene in disease progression



Elizabeth Verna, MD, MSc

Frank Cardile Associate Professor of Medicine
Director of Hepatology Research
Division of Digestive and Liver Diseases
Department of Medicine
Columbia University Irving Medical Center
New York, NY


Lisa B. VanWagner, MD, MSc, FAST, FAHA

Assistant Professor of Medicine and Preventive Medicine
Divisions of Gastroenterology & Hepatology and Division of Epidemiology
Northwestern University Feinberg School of Medicine
Chicago, IL

Accreditation/Credit Designation

Physicians’ Education Resource®, LLC, is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Physicians’ Education Resource®, LLC, designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Physicians’ Education Resource®, LLC, is approved by the California Board of Registered Nursing, Provider #16669, for 1.0 Contact Hours.

Faculty, Staff, and Planners’ Disclosures

The staff of Physicians’ Education Resource®, LLC have no relevant financial relationships with ineligible entities.

Elizabeth Verna, MD, MSc
  • Grant/Research Support: Salix Pharmaceuticals
Lisa B. VanWagner, MD, MSc, FAST, FAHA
  • Grant/Research Support: W.L. Gore & Associates

PER® mitigated all COI for faculty, staff, and planners prior to the start of this activity by using a multistep process.

Instructions for Participation and Credit

  1. Complete the activity (including pre- and post-activity assessments).
  2. Answer the evaluation questions.
  3. Request credit using the drop-down menu.
You may immediately download your certificate.

Course Viewing Requirements

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Google Chrome 28.0+ for Windows, Mac OS, or Linux
Mozilla Firefox 23.0+ for Windows, Mac OS, or Linux
Safari 6.0+ for Mac OSX 10.7 and above

Supported Phones & Tablets:
Android 4.0.3 and above
iPhone/iPad with iOS 6.1 or above

Off-Label Disclosure and Disclaimer

This activity may or may not discuss investigational, unapproved, or off-label use of drugs. Learners are advised to consult prescribing information for any products discussed. The information provided in this accredited activity is for continuing education purposes only and is not meant to substitute for the independent clinical judgment of a health care professional relative to diagnostic, treatment, or management options for a specific patient’s medical condition. The opinions expressed in the content are solely those of the individual faculty members and do not reflect those of PER® or any company that provided commercial support for this activity.