Inclusion Criteria:  adult patients (≥ 18 years) admitted to the University Medical Center Freiburg, Germany acute-on-chronic liver failure (ACLF) WITH acute kidney injury according to Kidney Disease: Improving Global Outcome (KDIGO) criteria stage 3 (≥ 3-fold increase of serum creatinine OR increase of serum creatinine to ≥ 4 mg/dl OR urine output ≤ 0.3 ml/kg/h for ≥ 24 hours OR anuria for ≥ 12 hours) AND serum bilirubin ≥ 5 mg/dl  Exclusion Criteria:  known patient will against participation in the study or against the measures applied in the study a decision made prior to inclusion to stop further treatment of the patient within the next 24 hours no complete remission of malignancy including hepatocellular carcinoma within the past 12 months patients on the waiting list for liver transplant or the potential option for being listed for liver transplant within the next 6 months liver cirrhosis in patients after liver transplantation ongoing intermittent or continuous renal replacement therapy before study inclusion