Pathogenesis of renal failure in cirrhosis and fulminant hepatic failure

Summary Acute renal failure in cirrhosis and fulminant hepatic failure represents a spectrum with ‘functional renal failure’ at one end and acute tubular necrosis at the other. In fulminant hepatic failure the development of renal failure is not necessarily a measure of the severity of liver damage. Functional renal failure is due to active renal vasoconstriction which may, at least in fulminant hepatic failure, be initiated by systemic endotoxaemia.