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Hepatorenal syndrome

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https://www.readbyqxmd.com/read/28433104/wilson-disease-symptomatic-liver-therapy
#1
Jan Pfeiffenberger, Karl-Heinz Weiss, Wolfgang Stremmel
Wilson disease leads to symptomatic impairment of liver function or liver cirrhosis. Strict adherence to decoppering agents is essential in these patients. Secondary prevention of additional hepatic damage by avoidance of other toxic substances (e.g., alcohol, drugs) and sufficient calorie intake is recommended. Routine examinations in cirrhotic patients include screening for signs of portal hypertension (esophagus varices), development of ascites, and hepatic encephalopathy. Where varices are present, primary or secondary preventive interventions may include treatment with nonselective beta-blockers or variceal ligation, similar to the approach in patients with liver cirrhosis due to other etiologies...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28420919/association-of-arginine-vasopressin-receptor-1a-gene-polymorphisms-with-hepatorenal-syndrome
#2
Chen Wang, Zhe Yu, Xin Luo, Jianhong Ye, Shourong Liu, Liangbin Miu, Jianfeng Bao, Fei Wang
OBJECTIVE: To assess the association of arginine vasopressin receptor 1a gene single nucleotide polymorphisms with type I hepatorenal syndrome. METHODS: The case-control study was conducted at the Hangzhou City Xixi Hospital, Hangzhou, China, from January 2012 to June 2014, and comprised patients with type I hepatorenal syndrome and individuals with cirrhosis who acted as the control group. Arginine vasopressin receptor 1a gene rs113481894 locus single nucleotide polymorphisms were analysed by high-resolution melting methods...
April 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28403995/comparative-efficacy-of-pharmacological-strategies-for-management-of-type-1-hepatorenal-syndrome-a-systematic-review-and-network-meta-analysis
#3
Antonio Facciorusso, Apoorva K Chandar, M Hassan Murad, Larry J Prokop, Nicola Muscatiello, Patrick S Kamath, Siddharth Singh
BACKGROUND: Several drugs have been studied to improve outcomes for patients with hepatorenal syndrome, but trials have reported variable efficacy. We aimed to compare the efficacy of different management strategies for type 1 hepatorenal syndrome. METHODS: For this systematic review and network meta-analysis, we searched Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid Embase, Ovid Cochrane Central Register of Controlled Trials, Scopus, and Web of Science for papers published up to June 9, 2016...
February 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28403987/terlipressin-for-hepatorenal-syndrome-ready-for-prime-time
#4
Pere Ginès
No abstract text is available yet for this article.
February 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28383303/early-hospital-readmissions-and-mortality-in-patients-with-decompensated-cirrhosis-enrolled-in-a-large-national-health-insurance-administrative-database
#5
Steven J Scaglione, Leanne Metcalfe, Stephanie Kliethermes, Ivan Vasilyev, Rebecca Tsang, Allyce Caines, Shaham Mumtaz, Vik Goyal, Asra Khalid, David Shoham, Talar Markossian, Amy Luke, Howard Underwood, Scott J Cotler
BACKGROUND: Patients with decompensated cirrhosis have high rates of morbidity and mortality and frequently require hospital admission. Few studies have examined early readmission as an indicator of 90 day and overall mortality. Analysis of large databases is needed to evaluate the association between early readmission and mortality in decompensated cirrhosis. METHODS: We analyzed 5 years of private, employer-based, health insurance claims data associated with HealthCare Services Corporation on 13...
April 5, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28370090/reversal-of-hepatorenal-syndrome-type-1-with-terlipressin-plus-albumin-vs-placebo-plus-albumin-in-a-pooled-analysis-of-the-ot-0401-and-reverse-randomised-clinical-studies
#6
A J Sanyal, T D Boyer, R T Frederick, F Wong, L Rossaro, V Araya, H E Vargas, K R Reddy, S C Pappas, P Teuber, S Escalante, K Jamil
BACKGROUND: The goal of hepatorenal syndrome type 1 (HRS-1) treatment is to improve renal function. Terlipressin, a synthetic vasopressin analogue, is a systemic vasoconstrictor used for the treatment of HRS-1, where it is available. AIM: To compare the efficacy of terlipressin plus albumin vs. placebo plus albumin in patients with HRS-1. METHODS: Pooled patient-level data from two large phase 3, randomised, placebo-controlled studies were analysed for HRS reversal [serum creatinine (SCr) value ≤133 μmol/L], 90-day survival, need for renal replacement therapy and predictors of HRS reversal...
March 29, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28364815/challenges-in-renal-failure-treatment-before-liver-transplant
#7
REVIEW
Fabrizio Fabrizi, Piergiorgio Messa
Acute kidney injury (AKI) is common in patients with cirrhosis and ascites on the waiting list for liver transplant. Hepatorenal syndrome (HRS) is an important cause of AKI among cirrhotics. A dynamic definition of AKI in patients with cirrhosis has been introduced and changed the diagnosis criteria. Liver transplantation remains the better option but the medical management of HRS has changed. Terlipressin plus albumin is currently the gold standard. Surgery and liver or kidney support systems have been recommended...
May 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/28321803/prognosis-of-cirrhotic-patients-admitted-to-intensive-care-unit-a-meta-analysis
#8
Delphine Weil, Eric Levesque, Marc McPhail, Rodrigo Cavallazzi, Eleni Theocharidou, Evangelos Cholongitas, Arnaud Galbois, Heng Chih Pan, Constantine J Karvellas, Bertrand Sauneuf, René Robert, Jérome Fichet, Gaël Piton, Thierry Thevenot, Gilles Capellier, Vincent Di Martino
BACKGROUND: The best predictors of short- and medium-term mortality of cirrhotic patients receiving intensive care support are unknown. METHODS: We conducted meta-analyses from 13 studies (2523 cirrhotics) after selection of original articles and response to a standardized questionnaire by the corresponding authors. End-points were in-ICU, in-hospital, and 6-month mortality in ICU survivors. A total of 301 pooled analyses, including 95 analyses restricted to 6-month mortality among ICU survivors, were conducted considering 249 variables (including reason for admission, organ replacement therapy, and composite prognostic scores)...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28303201/erratum-metabolic-syndrome-and-the-hepatorenal-reflex
#9
(no author information available yet)
[This corrects the article on p. 83 in vol. 7, PMID: 27656314.].
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28297776/-value-of-thromboelastography-in-evaluating-coagulation-function-and-prognosis-in-patients-with-acute-on-chronic-liver-failure
#10
Y L Zeng, F Gao, J F Wei, H R Hou, X Jin, G G Ding, H Yin, J Shang, Y Kang
Objective: To investigate the coagulation function in patients with acute-on-chronic liver failure (ACLF) patients using thromboelastography (TEG), and to comprehensively and dynamically evaluate patients' bleeding and coagulation status. Methods: The clinical data of ACLF patients were collected, and TEG was used to evaluate whole blood clotting kinetics in these patients. Routine biochemical parameters were measured, and complications were evaluated. The t-test was used for comparison of continuous data, the chi-square test was used for comparison of categorical data, and the Pearson correlation coefficient was used for correlation analysis...
January 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/28293919/-extracorporeal-liver-support-of-liver-failure
#11
Hans Ulrich Gerth, Michele Pohlen, Hermann Pavenstädt, Hartmut Schmidt
Extracorporeal liver support can be classified into cell-free, artificial methods (artificial liver support, ALS) and cell-based bioartificial methods (bioartificial liver support, BLS). ALS improves biochemical parameters of liver failure by the simultaneous removal of protein-bound and water-soluble substances. Here, the MARS therapy belongs to the most studied methods with a proved beneficial effect on hepatic encephalopathy (HE), hepatorenal syndrome (HRS) or hyperbilirubinemia. However, a general survival advantage of any liver support for liver failure has not been shown yet and is restricted to meta-analyses or patient subgroups...
April 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28293378/hepatorenal-syndrome-update-on-diagnosis-and-therapy
#12
EDITORIAL
Juan G Acevedo, Matthew E Cramp
Hepatorenal syndrome (HRS) is a manifestation of extreme circulatory dysfunction and entails high morbidity and mortality. A new definition has been recently recommended by the International Club of Ascites, according to which HRS diagnosis relies in serum creatinine changes instead that on a fixed high value. Moreover, new data on urinary biomarkers has been recently published. In this sense, the use of urinary neutrophil gelatinase-associated lipocalin seems useful to identify patients with acute tubular necrosis and should be employed in the diagnostic algorithm...
February 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28245243/serelaxin-as-a-potential-treatment-for-renal-dysfunction-in-cirrhosis-preclinical-evaluation-and-results-of-a-randomized-phase-2-trial
#13
Victoria K Snowdon, Neil J Lachlan, Anna M Hoy, Patrick W F Hadoke, Scott I Semple, Dilip Patel, Will Mungall, Timothy J Kendall, Adrian Thomson, Ross J Lennen, Maurits A Jansen, Carmel M Moran, Antonella Pellicoro, Prakash Ramachandran, Isaac Shaw, Rebecca L Aucott, Thomas Severin, Rajnish Saini, Judy Pak, Denise Yates, Neelesh Dongre, Jeremy S Duffield, David J Webb, John P Iredale, Peter C Hayes, Jonathan A Fallowfield
BACKGROUND: Chronic liver scarring from any cause leads to cirrhosis, portal hypertension, and a progressive decline in renal blood flow and renal function. Extreme renal vasoconstriction characterizes hepatorenal syndrome, a functional and potentially reversible form of acute kidney injury in patients with advanced cirrhosis, but current therapy with systemic vasoconstrictors is ineffective in a substantial proportion of patients and is limited by ischemic adverse events. Serelaxin (recombinant human relaxin-2) is a peptide molecule with anti-fibrotic and vasoprotective properties that binds to relaxin family peptide receptor-1 (RXFP1) and has been shown to increase renal perfusion in healthy human volunteers...
February 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28226199/mortality-risk-factors-among-patients-with-cirrhosis-and-a-low-%C3%A2-15-meld-sodium-score-an-analysis-of-liver-transplant-allocation-policy-using-aggregated-electronic-health-record-data
#14
K Atiemo, A Skaro, H Maddur, L Zhao, S Montag, L VanWagner, S Goel, A Kho, B Ho, R Kang, J L Holl, M M Abecassis, J Levitsy, D P Ladner
Although the MELDNa score is now used for liver transplant allocation in the United States, mortality prediction may be underestimated by the score. Using aggregated electronic health record data from 7,834 adult patients with cirrhosis, we determined whether the cause of cirrhosis/cirrhosis complications is associated with an increased risk of death among patients with a MELDNa ≤15 and whether patients with the greatest risk of death could benefit from liver transplantation (LT). Over a median follow-up of 2...
February 22, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28176190/relative-adrenal-insufficiency-in-patients-with-cirrhosis-a-systematic-review-and-meta-analysis
#15
Gaeun Kim, Ji Hye Huh, Kyong Joo Lee, Moon Young Kim, Kwang Yong Shim, Soon Koo Baik
BACKGROUND: Relative adrenal insufficiency (RAI) is frequently observed in patients with cirrhosis. We sought to identify evidence in the literature regarding the impact of RAI on clinical outcomes in cirrhotic patients. METHODS: We conducted a systematic review (SR) and meta-analysis (MA) using the Ovid-MEDLINE, EMBASE, and Cochrane Library databases to identify relevant studies in the literature. RESULTS: Of the 182 studies identified, 16 were eligible according to our inclusion criteria...
April 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28151755/renal-cystic-disease-and-associated-ciliopathies
#16
Karl O Kagan, Andreas Dufke, Ulrich Gembruch
PURPOSE OF REVIEW: To review disorders that are associated with renal cystic disease during prenatal life and to highlight the strong association between renal cystic disease and ciliopathies. RECENT FINDINGS: There are numerous causative genes for ciliopathies that can present with cystic kidney disease. In the group of single gene ciliopathies, autosomal dominant polycystic kidney disease is by far the most prevalent one. Other examples are autosomal recessive polycystic kidney disease, nephronophthisis, Bardet-Biedl syndrome, Meckel-Gruber syndrome, Joubert syndrome and related disorders as well as X-linked orofaciodigital syndrome type 1, respectively...
April 2017: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28124314/microalbuminuria-systemic-inflammation-and-multiorgan-dysfunction-in-decompensated-cirrhosis-evidence-for-a-nonfunctional-mechanism-of-hepatorenal-syndrome
#17
EDITORIAL
Vicente Arroyo
No abstract text is available yet for this article.
January 25, 2017: Hepatology International
https://www.readbyqxmd.com/read/28112958/cutaneous-necrosis-secondary-to-terlipressin-therapy-a-rare-but-serious-side-effect-case-report-and-literature-review
#18
Enrique Iglesias Julián, Ester Badía Aranda, Belén Bernad Cabredo, Daniel Corrales Cruz, María José Romero Arauzo
Terlipressin is a vasopressin analogue used in esophageal variceal bleeding and hepatorenal syndrome management. It is a safe drug with mild secondary effects. However, potentially serious ischemic complications may occur, such as cutaneous necrosis. It is useful to recognize these events early, in order to withdraw terlipressin and introduce other adjuvant drugs if needed. We report a detailed case of cutaneous necrosis secondary to terlipressin administration and present a case review of patients, describing their characteristics, risk factors, lesion locations, doses, methods of administration and possible treatments...
January 23, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28074870/microrna-155-is-upregulated-in-ascites-in-patients-with-spontaneous-bacterial-peritonitis
#19
Philipp Lutz, Mohamed M Haimid, Alessandra Pohlmann, Jennifer Lehmann, Christian Jansen, Robert Schierwagen, Sabine Klein, Christian P Strassburg, Ulrich Spengler, Jonel Trebicka
MircoRNA's (miR) have been recognised as important modulators of gene expression and potential biomarkers. However, they have been rarely investigated in bio fluids apart from blood. We investigated the association of miR-125b and miR-155 with complications of cirrhosis. Ascites was prospectively collected from patients with cirrhosis undergoing paracentesis at our department. miR's were determined in the supernatant using qPCR and normalized by SV-40. Clinical parameters were assessed at paracentesis and during follow-up...
January 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28052631/why-and-how-to-measure-renal-function-in-patients-with-liver-disease
#20
REVIEW
Salvatore Piano, Antonietta Romano, Marco Di Pascoli, Paolo Angeli
Patients with advanced liver disease frequently have impaired renal function. Both acute kidney injury (AKI) and chronic kidney disease (CKD) are quite common in patients with cirrhosis and both are associated with a worse prognosis in these patients. A careful assessment of renal function is highly important in these patients to help physicians determine their diagnosis, prognosis and therapeutic management and to define transplantation strategies (liver transplantation alone vs simultaneous liver and kidney transplantation)...
January 2017: Liver International: Official Journal of the International Association for the Study of the Liver
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