Clinical Recommendations of the Russian Scientific Liver Society and Russian Gastroenterological Association on Diagnosis and Treatment of Liver Fibrosis, Cirrhosis and Their Complications

Abstract

Aim. Current clinical recommendations are intended to supply gastroenterologists, physicians and general practitioners with modern methods for the diagnosis and treatment of liver cirrhosis and fibrosis.Key points. Liver fibrosis develops with connective tissue accumulation in liver in the outcome of various chronic diseases, including alcohol misuse, viral hepatitises, autoimmune and more rare hereditary liver diseases. Liver cirrhosis is the final stage of most chronic diffuse liver diseases. The recommendations present current opinions on pathogenesis of liver fibrosis and cirrhosis, principles of diagnosis, treatment and prevention of their main complications: hepatic encephalopathy, oesophageal and gastric variceal bleeding, acute kidney injury/hepatorenal syndrome, infectious complications (i.a. spontaneous bacterial peritonitis), hyponatraemia, pulmonary complications, etc.Conclusion. Timely diagnosis and adequate therapy in cirrhosis can prevent life-threatening complications and improve the patients’ prognosis and quality of life.

Keywords

• liver cirrhosis and fibrosis
• decompensation
• liver failure
• portal hypertension
• ascites
• hepatic hydrothorax
• spontaneous bacterial peritonitis
• oesophageal varices
• hepatic encephalopathy
• hyponatraemia
• acute kidney injury
• hepatorenal syndrome