Administration of terlipressin and albumin (SOC) in both groups
AKI, inferior vena cava diameter, volume overload albumin
REGRESSION, VOLUME OVERLOAD
Once the diagnosis of HRS-AKI is established, the standard of care will be administered according to actual clinical practice guidelines [All patients with AKI will receive according to clinical practice guidelines albumin infusion 1 g/kg infusion (up to a maximum of 100 g) for 2 days [Terlipressin will be started in continuous perfusion (2–4 mg per day) and will be increased in a stepwise fashion every 2–3 days in the case of non-response of serum creatinine (decrease in serum creatinine < 25% from peak value). The maximum dose of terlipressin is 12 mg/day. Albumin will be given at a dose between 20 and 40 mg per day and adjusted according to the volume status of the patient. Treatment will be maintained until achieving a full response (defined by regression of serum creatinine to 26.5 µmol/L from baseline value) or a maximum of 14 days.Special attention will be given to volume overload. This will include daily physical examination including pulmonary auscultation and if considered necessary by the managing physician chest X-ray or measurement of central venous pressure or inferior vena cava diameter on ultrasound. If clinical suspicion of mild volume overload albumin will be reduced, if clinical suspicion of severe volume overload albumin will be temporarily suspended. Veno-venous hemodialysis will be initiated according to the decision of the managing physician. It is recommended that patients who require veno-venous hemodialysis do not receive further treatment with terlipressin + / − albumin. The patient will remain in the study for the intention to treat analysis regarding the main end-point.