**16. Conclusions**

ALF and ACLF represent very complex pathophysiological diseases that encompass multiple inflammation mechanisms that perpetuate liver damage and medical treatment is not successful in limiting the damage. The use of albumin-based extracorporeal support therapies has not been shown to have an impact on survival and we see plasma exchange therapies or therapies combined with hemoperfusion show better survival than the traditional ones, although more randomized controlled trials with a greater number of patients are needed of patients to have a stronger recommendation.

Hepatorenal syndrome is a renal complication in patients with advanced liver cirrhosis and is triggered by multiple mechanisms. There is no gold standard for diagnosis, which is by exclusion, albumin and Terlipressin therapy is the recommended treatment in response to treatment with higher mortality, which is not modified by the use of renal support therapies.

*Updates on Hemodialysis*
