# Hepato-Renal Crosstalk in Acute and Chronic Disease: From Shared Pathways to Therapeutic Targets

## TL;DR

This review explores how liver and kidney diseases influence each other and emphasizes the need for a combined approach to improve patient care.

## Contribution

The paper provides a comprehensive review of hepato-renal crosstalk mechanisms and their clinical implications.

## Key findings

- Liver and kidney diseases share overlapping pathways that affect each other's function.
- Acute kidney injury and hepatorenal syndrome are critical areas where this crosstalk is evident.
- A multidisciplinary approach is essential for managing these interconnected conditions.

## Abstract

Hepato-renal crosstalk is a complex biological communication between liver and kidneys mediated by various factors, including cellular, endocrine, and paracrine molecules. This interaction highlights the functional consequences that damage in one organ can have on the other. In particular, the liver and kidney play a pivotal role in maintaining body homeostasis, as they are both involved in the excretion of toxic bioproducts and drugs. The overlap of liver and kidney disease has both therapeutic and prognostic implications. Therefore, a better understanding of the mechanisms involved in the pathogenesis of this bidirectional crosstalk is essential for improving the management of these clinical conditions and patient outcomes. Specifically, a multidisciplinary approach involving hepatologists and nephrologists is crucial to reduce the long-term burden of these clinical settings. This review focuses on the hepato-renal crosstalk in the context of liver and kidney disease, with particular attention to acute kidney injury associated with liver injury, hepatorenal syndrome and, chronic kidney disease in the context of liver fibrosis.