A Review of Advancements in Hepatorenal Syndrome Acute Kidney Injury (HRS AKI) Treatment Approaches to Improve Patient Outcomes

A Review of Advancements in Hepatorenal Syndrome Acute Kidney Injury (HRS AKI) Treatment Approaches to Improve Patient Outcomes

Faculty Presenter

Lauren A Igneri, PharmD, BCPS, BCCCP
Critical Care Clinical Pharmacy Specialist
Cooper University Health Care
Camden, New Jersey
 
Program Description
Hepatorenal syndrome acute kidney injury (HRS AKI) is a life-threatening and rapidly progressive condition typically occurring in patients with advanced liver disease and leading to acute renal failure. The exact pathophysiology of HRS is not fully understood, but it is associated with high mortality rates and, if left untreated, 80% of patients with HRS AKI do not survive beyond 2 weeks. HRS is the leading cause of hospitalizations among patients with chronic liver disease and a cause of increased readmission rates and high treatment costs. There is currently no FDA-approved therapy for HRS AKI in the United States, but the mainstay of management is supportive care and use of albumin and vasoconstrictors to improve short-term outcomes until a liver transplant is available. Health-system pharmacists must be familiar with HRS AKI management including clinical trial data, dosing, titration, and monitoring parameters for current and emerging therapies. Pharmacists can work closely with the health care team to manage this high-risk patient population by making appropriate dosing and titration recommendations and monitoring drug therapy to ensure safe drug use. This activity will review current and emerging treatment approaches in HRS and the role of the health-system pharmacist in serving as a bridge between physicians and patients with HRS.

Target audience: Health-system pharmacists and retail pharmacists
Type of activity: Application
Release date: April 15, 2021
Expiration date: April 15, 2022
Time to complete activity: 2 hours
Fee: Free

Educational Objectives
At the completion of this activity, participants will be able to:

• Analyze the pathophysiology, risk factors, and etiology of disease to recognize the clinical distinction between hepatorenal syndrome acute kidney injury (HRS AKI) and non-acute kidney injury (HRS NAKI)
• Explain the use of vasoconstrictors in the management of HRS AKI and role of terlipressin in treatment
• Illustrate the role of the pharmacist in selecting appropriate therapy and tailoring regimens to individual patients

 Pharmacy Times Continuing Education™ is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 2.0 contact hours (0.20 CEU) under the ACPE universal activity number 0290-0000-21-119-H01-P. The activity is available for CE credit through April 15, 2022.


Instructions for Completing the Activity and Receiving CPE Credit
To receive CPE credit, participants must complete the pretest, read the article in its entirety, complete the posttest, and complete the online activity evaluation. After successful completion of the online activity evaluation, you can submit your credit to CPE Monitor. You may view your credit within 48 hours at www.mycpemonitor.net. All participants must request credit before the activity expiration date. CE credit will not be issued after this date.
 

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Disclosures

Lauren A Igneri, PharmD, BCPS, BCCCP, has no relevant financial relationships with commercial interests to disclose.

Pharmacy Times Continuing Education™ Planning Staff – Jim Palatine, RPh, MBA; Maryjo Dixon, RPh; Rose Namissa, PharmD, BCPS; Kelly McCormick; Susan Pordon; and Brianna Winters have no relevant financial relationships with commercial interests to disclose.

An anonymous peer reviewer is used as part of content validation and conflict resolution. The peer reviewer has no relevant financial relationships with commercial interests to disclose.


Educational Disclaimer
CPE activities are offered solely for educational purposes and do not constitute any form of professional advice or referral. Discussions concerning drugs, dosages, and procedures may reflect the clinical experience of the author(s) or they may be derived from the professional literature or other sources and may suggest uses that are investigational in nature and not approved labeling or indications. Participants are encouraged to refer to primary references or full prescribing information resources.

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