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Hepatorenal syndrome

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https://www.readbyqxmd.com/read/29240010/well-preserved-renal-function-in-children-with-untreated-chronic-liver-disease
#1
Ulla B Berg, Antal Németh
OBJECTIVES: Based on studies with hepatorenal syndrome, it is widely regarded that renal function is impacted in chronic liver disease. Therefore we investigated renal function in our children with chronic liver disease. METHODS: In a retrospective study of 277 children with chronic liver disease, renal function was investigated as glomerular filtration rate (GFR) and effective renal plasma flow (ERPF), measured as clearance of inulin and para-amino hippuric acid or clearance of iohexol...
December 12, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29239266/epidemiology-of-invasive-pulmonary-aspergillosis-in-patients-with-liver-failure-clinical-presentation-risk-factors-and-outcomes
#2
Xuan Zhang, Meifang Yang, Jianhua Hu, Hong Zhao, Lanjuan Li
Objective Invasive pulmonary aspergillosis (IPA) is a severe and often lethal infection. The possible risk factors, clinical presentation, and treatment of patients with simultaneous liver failure and IPA have received little attention in previous studies. The aim of this study was to investigate the epidemiology of IPA in patients with liver failure in an effort to reduce patient mortality. Methods The patients with liver failure (including acute liver failure , sub-acute liver failure , acute-on-chronic liver failure and chronic liver failure) were recruited from 2011 to 2016...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/29151800/hepatorenal-syndrome-role-of-the-transjugular-intrahepatic-stent-shunt-in-real-life-practice
#3
Gianni Testino
No abstract text is available yet for this article.
2017: Clujul Medical (1957)
https://www.readbyqxmd.com/read/29129539/leptospirosis-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#4
REVIEW
Juan Ignacio Silesky Jiménez, Jorge Luis Hidalgo Marroquin, Guy A Richards, Pravin Amin
Leptospirosis is a zoonosis caused by a gram negative aerobic spirochete of the genus Leptospira. It is acquired by contact with urine or reproductive fluids from infected animals, or by inoculation from contaminated water or soil. The disease has a global distribution, mainly in tropical and subtropical regions that have a humid, rainy climate and is also common in travelers returning from these regions. Clinical suspicion is critical for the diagnosis and it should be included in the differential diagnosis of any patient with a febrile hepatorenal syndrome in, or returning from endemic regions...
November 9, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29122911/prognosis-of-patients-with-cirrhosis-and-aki-who-initiate-rrt
#5
Andrew S Allegretti, Xavier Vela Parada, Nwamaka D Eneanya, Hannah Gilligan, Dihua Xu, Sophia Zhao, Jules L Dienstag, Raymond T Chung, Ravi I Thadhani
BACKGROUND AND OBJECTIVES: Literature on the prognosis of patients with cirrhosis who require RRT for AKI is sparse and is confounded by liver transplant eligibility. An update on outcomes in the nonlisted subgroup is needed. Our objective was to compare outcomes in this group between those diagnosed with hepatorenal syndrome and acute tubular necrosis, stratifying by liver transplant listing status. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Retrospective cohort study of patients with cirrhosis acutely initiated on hemodialysis or continuous RRT at five hospitals, including one liver transplant center...
November 9, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29115798/acute-alcoholic-hepatitis-a-literature-review-and-proposal-of-treatment
#6
Gianni Testino, Silvia Leone
Severe acute alcoholic hepatitis (AAH) can lead to a clinical picture with a sixmonth mortality rate in more than 70% of cases. This clinical picture is characterized by: jaundice with a duration of less than three months, jaundice at the first failure event, serum bilirubin greater than 5 mg / dL, ratio AST / ALT> 2: 1, AST less than 500 IU / L, ALT <300 IU / L, neutrophil leukocytosis and a GGT increase. In addition, encephalopathy, fever, asthenia and coagulopathy may be present. Its onset may also be characterized by portalhypertensionrelated complications, particularly bleeding and hepatorenal syndrome...
November 7, 2017: Minerva Medica
https://www.readbyqxmd.com/read/29111999/terlipressin-is-superior-to-midodrine-octreotide-for-hepatorenal-syndrome-type-1
#7
Georgios N Kalambokis, Gerasimos Baltayiannis, Dimitrios Christodoulou, Leonidas Christou
No abstract text is available yet for this article.
December 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29081628/terlipressin-induced-peripheral-ischemic-gangrene-in-a-diabetic-patient
#8
Phulen Sarma, Gaurav Muktesh, Narender Dhaka, Rakesh Ruhela, Abhishek Mishra, Rahul Singh, Saroj K Sinha, Bikash Medhi, Rakesh Kochhar
Terlipressin is used commonly in the management of hepatorenal syndrome and acute variceal bleeding. Like its parent compound vasopressin, it is also notorious for its ischemic complications. Terlipressin-induced ischemic complications can virtually affect any part of the body, but the incidence of serious complications is less than its parent compound vasopressin. Here, we report a case of terlipressin-induced peripheral ischemic gangrene in a diabetic male, which ultimately led to death of the patient.
July 2017: Journal of Pharmacology & Pharmacotherapeutics
https://www.readbyqxmd.com/read/29075990/biology-of-portal-hypertension
#9
REVIEW
Matthew McConnell, Yasuko Iwakiri
Portal hypertension develops as a result of increased intrahepatic vascular resistance often caused by chronic liver disease that leads to structural distortion by fibrosis, microvascular thrombosis, dysfunction of liver sinusoidal endothelial cells (LSECs), and hepatic stellate cell (HSC) activation. While the basic mechanisms of LSEC and HSC dysregulation have been extensively studied, the role of microvascular thrombosis and platelet function in the pathogenesis of portal hypertension remains to be clearly characterized...
October 26, 2017: Hepatology International
https://www.readbyqxmd.com/read/29054321/noradrenaline-as-an-alternative-medical-treatment-to-terlipressin-in-the-management-of-hepatorenal-syndrome-type-1
#10
Carmen Sendra, María Del Pilar Silva Ruiz, María Teresa Ferrer Rios, José Carlos Alarcón García, Juan Manuel Pascasio Acevedo
No abstract text is available yet for this article.
October 17, 2017: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/29052317/defective-ciliogenesis-in-inpp5e-related-joubert-syndrome
#11
Isabel Hardee, Ariane Soldatos, Mariska Davids, Thierry Vilboux, Camilo Toro, Karen L David, Carlos R Ferreira, Michele Nehrebecky, Joseph Snow, Audrey Thurm, Theo Heller, Ellen F Macnamara, Meral Gunay-Aygun, Wadih M Zein, William A Gahl, May Christine V Malicdan
Joubert syndrome is a neurodevelopmental disorder, characterized by malformation of the mid and hindbrain leading to the pathognomonic molar tooth appearance of the brainstem and cerebellum on axial MRI. Core clinical manifestations include hypotonia, tachypnea/apnea, ataxia, ocular motor apraxia, and developmental delay of varying degrees. In addition, a subset of patients has retinal dystrophy, chorioretinal colobomas, hepatorenal fibrocystic disease, and polydactyly. Joubert syndrome exhibits genetic heterogeneity, with mutations identified in more than 30 genes, including INPP5E, a gene encoding inositol polyphosphate 5-phosphatase E, which is important in the development and stability of the primary cilium...
December 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/29023314/renal-dysfunction-and-cirrhosis
#12
François Durand, Jody C Olson, Mitra K Nadim
PURPOSE OF REVIEW: Hepatorenal syndrome (HRS) does not represent the predominant phenotype of acute kidney injury (AKI) in cirrhosis. Early recognition of HRS helps initiate appropriate therapy. The aims of this review are to present redefinition of AKI, to list new biomarkers, to report recent data on vasopressors in HRS and to propose criteria for simultaneous liver and kidney transplantation (SLKT). RECENT FINDINGS: Urine output, which was not part of the definition of AKI might be reconsidered as it has an independent prognostic value...
December 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29018183/a-case-of-left-renal-vein-ligation-in-a-patient-with-solitary-left-kidney-undergoing-liver-transplantation-to-control-splenorenal-shunt-and-improve-portal-venous-flow
#13
Rodrigo B Martino, Eserval Rocha Júnior, Valdano Manuel, Vinicius Rocha-Santos, Luis Augusto C D'Albuquerque, Wellington Andraus
BACKGROUND Adequate portal venous flow is required for successful liver transplantation. Reduced venous flow and blood flow 'steal' by collateral vessels are a concern, and when there is a prominent splenorenal shunt present, ligation of the left renal vein has been recommended to improve portal venous blood flow. CASE REPORT A 51-year-old man who had undergone right nephrectomy in childhood required liver transplantation for liver cirrhosis and hepatocellular carcinoma due to hepatitis C virus (HCV) infection...
October 11, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28991106/pharmacological-therapies-for-hepatorenal-syndrome-a-systematic-review-and-meta-analysis
#14
Arjun Nanda, Rewanth Reddy, Humaira Safraz, Salameh Habeeb, Ashwani K Singal
BACKGROUND: Hepatorenal syndrome (HRS) is a serious complication of advanced chronic liver disease. Different pharmacological therapies have variable efficacy. We performed a systematic review and meta-analysis to compare the efficacy of various drugs in the treatment of HRS. STUDY: Randomized controlled trials comparing active drug with placebo or comparing 2 different drugs were included in this analysis. Primary study outcome was reversal of HRS. Secondary outcomes were HRS relapse and patient survival...
October 4, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28981166/terlipressin-current-and-emerging-indications-in-chronic-liver-disease
#15
REVIEW
Timothy Papaluca, Paul Gow
Terlipressin is an analogue of vasopressin that has potent vasoactive properties and has been available for use in most countries for nearly two decades. It has both established roles and emerging indications in the management of complications of decompensated chronic liver disease. We explore historic and emerging literature regarding the use of terlipressin for a range of indications including hepatorenal syndrome, portal hypertensive bleeding and disruptions in sodium homeostasis. Novel methods of infusion based terlipressin administration including the beneficial effect in reduction of adverse events are explored, in addition to new indications for the use of terlipressin in decompensated cirrhosis in an outpatient setting...
October 5, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28972485/peculiarities-of-the-clinical-course-of-non-alcoholic-steatohepatitis-against-the-background-of-the-chronic-kidney-disease-of-the-i-iii-stage-with-secondary-arterial-hypertension
#16
O Hukhlina, A Antoniv, I Dudka, T Dudka, O Mandryk
The article addresses the theoretical generalization of the clinical study of non-alcoholic steatohepatitis peculiarities in comorbidity with obesity and chronic kidney disease of the І-ІІІ stage, characterized by higher frequency and intensity of clinical and biochemical syndromes, the manifestation of which is likely to increase the occurrence of secondary arterial hypertension (portal hypertension syndromes, cholestasis, mesenchymal inflammation). Comorbid course of non-alcoholic steatohepatitis with chronic kidney disease is characterized by higher degree of liver steatosis compared to the patients with only non-alcoholic steatohepatitis (p<0...
September 2017: Georgian Medical News
https://www.readbyqxmd.com/read/28953318/terlipressin-versus-other-vasoactive-drugs-for-hepatorenal-syndrome
#17
REVIEW
Mads Israelsen, Aleksander Krag, Andrew S Allegretti, Manol Jovani, Alison H Goldin, Rachel W Winter, Lise Lotte Gluud
BACKGROUND: Hepatorenal syndrome is defined as severe renal failure occurring in people with cirrhosis and ascites. Systematic reviews of randomised clinical trials found that, compared with placebo, terlipressin may reduce mortality and improve renal function in people with hepatorenal syndrome, but we need current evidence from systematic reviews on the benefits and harms of terlipressin versus other vasoactive drugs. OBJECTIVES: To evaluate the beneficial and harmful effects of terlipressin versus other vasoactive drugs for people with hepatorenal syndrome...
September 27, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28953058/albumin-use-in-patients-with-cirrhosis-in-france-results-of-the-albu-live-survey-a-case-for-better-easl-guidelines-diffusion-and-or-revision
#18
Armand Garioud, Jean-François Cadranel, Arnaud Pauwels, Jean-Baptiste Nousbaum, Thierry Thévenot, Thong Dao, Alexandre Louvet, Philippe Sogni, Nathalie Talbodec, Teresa M Antonini, Christophe Bureau, Dominique Thabut, Laure Elkrief, Vincent Jouannaud, Gilles Macaigne, Brigitte Bernard-Chabert, Hortensia Lison, Laurent Alric, Nicolas Carbonell, Héléne Labadie, Xavier Amiot, Armand Abergel, Bertrand Hanslik, Vincent Leroy, Victor De Lédinghen, Jacques Denis
INTRODUCTION: The use of human albumin for the management of cirrhosis has increased. Recommendations have been published for therapeutic paracentesis (TP), spontaneous bacterial peritonitis (SBP), and type 1 hepatorenal syndrome (HRS). The goal of this survey was to assess the prescription practices of French hepatogastroenterologists. METHODS: All hepatogastroenterologists were contacted. The questionnaire evaluated (1) the use of albumin in validated indications and (2) the prescription of albumin for nonvalidated clinical situations...
August 4, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28924736/vasoactive-agents-for-hepatorenal-syndrome-a-mixed-treatment-comparison-network-meta-analysis-and-trial-sequential-analysis-of-randomized-clinical-trials
#19
Kannan Sridharan, Gowri Sivaramakrishnan
BACKGROUND: Hepatorenal syndrome (HRS) is a common complication among patients with cirrhosis, primarily attributable to vasodilation of renal vessels. Vasoactive agents are commonly used to treat HRS. The present network meta-analysis compares the vasoactive agents used in HRS. METHODS: We searched electronic databases for appropriate randomized controlled clinical trials in patients with HRS, comparing active interventions with either placebo or standard of care...
September 18, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28919607/impact-of-adrenocortical-insufficiency-on-clinical-parameters-in-haemodynamically-stable-cirrhotic-patients-with-ascites
#20
H Ahmed, M R Karim, R K Paul, M Chowdhury, M S Alam, A Saha, F Rahman, M A Rouf
Cirrhosis has many complications regardless of the aetiology. Complications include splenomegaly, ascites, hepatic encephalopathy, spontaneous bacterial peritonitis, hepatorenal syndrome and hepatocellular carcinoma and also linked to abnormalities in the endocrine system, including abnormal sex hormone metabolism, thyroid disease, osteoporosis, and, most recently identified, adrenal insufficiency. This prospective cohort study was done to evaluate the impact of adrenocortical insufficiency on clinical parameters in haemodynamically stable cirrhotic patients with ascites and had been performed at the inpatient of GHPD Department, BIRDEM, Dhaka, Bangladesh from April 2011 to March 2012...
July 2017: Mymensingh Medical Journal: MMJ
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