1. Greater emphasis should be placed on accurate measurement
and/or estimation of baseline GFR using multiple
techniques or equations where available. This should
be followed with serial measurements over time. Rapid
bedside measurement of GFR using carobymethylated
dextrans holds significant potential in this regard. For estimation
of GFR, ESLD-specific formulae need to be developed
and validated in large cohorts, especially among those
with GFR of <30 mL/min.

2. Multidimentional diagnostic work up should be pursued
in LT candidates with AKI. Treatment for common causes
of AKI should be started concurrently. In general volume
expansion with albumin, withholding diuretics, and treatment
of potential infections should be started with antibiotics.
Further therapies should be directed at specific causes.

3. Elevating MAPs with the help of vasopressor agents are
important in reversing HRS pathology. Terlipressin, which
has been recently approved for use in the United States,
should be used early in suspected HRS, and protocols need
to be developed in expanding its use.

4. RRT therapy should be used judiciously, taking into
account chances of getting to LT, frailty, and overall potential
duration of RRT. It can be used as an effective bridge
to LT.