Supplementary Material for: Current Concepts in the Diagnosis and Classification of Renal Dysfunction in Cirrhosis

<b><i>Background:</i></b> Renal dysfunction is one of the most common complications of cirrhosis with high morbidity and mortality. <b><i>Summary:</i></b> In subjects with cirrhosis, renal dysfunction can present either as a direct consequence of cirrhosis (e.g. hepatorenal syndrome type I and type II) or secondary to etiologies other than cirrhosis (chronic kidney disease due to diabetic nephropathy, prerenal azotemia), or patients with cirrhosis may have renal dysfunction resulting directly from cirrhosis and an underlying chronic kidney disease. <b><i>Key Messages:</i></b> Given the challenges in the differential diagnosis of renal dysfunction and insufficient accuracy of serum creatinine and creatinine-based glomerular filtration rate estimating equations in cirrhosis, there is an urgent need for more accurate biomarkers of renal dysfunction in this population. This review will discuss novel concepts for the diagnosis and classification of renal dysfunction in cirrhosis to overcome at least some of the diagnostic and therapeutic challenges. Additionally, a new classification will be proposed for renal dysfunction in cirrhosis.

**背景：** 肾功能不全（renal dysfunction）是肝硬化（cirrhosis）最常见的并发症之一，具有较高的发病率与死亡率。
**概述：** 对于肝硬化患者而言，肾功能不全既可作为肝硬化的直接并发症出现（例如Ⅰ型与Ⅱ型肝肾综合征（hepatorenal syndrome）），也可继发于肝硬化以外的病因（如糖尿病肾病所致慢性肾脏病（chronic kidney disease）、肾前性氮质血症（prerenal azotemia））；部分肝硬化患者还可能同时存在肝硬化直接引发的肾功能不全，以及潜在的慢性肾脏病。
**核心要点：** 鉴于肝硬化患者肾功能不全的鉴别诊断存在诸多难点，且血清肌酐（serum creatinine）及基于肌酐的肾小球滤过率（glomerular filtration rate）估算公式在该人群中准确性不足，因此亟需更为精准的肾功能不全生物标志物（biomarker）。本综述将探讨肝硬化患者肾功能不全的诊断与分型新理念，以至少部分解决当前诊断与治疗方面的困境；此外，还将针对肝硬化患者的肾功能不全提出全新的分型方案。