Figure 4.

Clinical implications of systemic inflammation in cirrhosis. Systemic inflammation is a distinct feature of cirrhosis and acts in synergy with other pathophysiological mechanisms leading to acute decompensation; hepatic encephalopathy, portal hypertensive bleeding, and ascites. It is also central to the development of HRS-AKI and infection, notably when accompanied by immunoparesis. High-grade systemic inflammation, at the most severe end of the spectrum, triggers the development of ACLF. Systemic inflammation may also play a role in HCC development and depression. Created with biorender.com. ACLF, acute-on-chronic liver failure; HCC, hepatocellular carcinoma; HRS-AKI, hepatorenal syndrome–acute kidney injury.