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Hepatorenal syndrome

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https://www.readbyqxmd.com/read/29893703/urinary-neutrophil-gelatinase-associated-lipocalin-in-cirrhotic-patients-with-acute-kidney-injury
#1
Hassan S Hamdy, Ahmed El-Ray, Mohamed Salaheldin, Mohammad Lasheen, Mohamed Aboul-Ezz, Ahmed S Abdel-Moaty, Ali Abdel-Rahim
INTRODUCTION AND AIM: It is well known that development of acute kidney injury (AKI) increases mortality in hospitalized cirrhotic patients; therefore many novel markers have been studied for early detection, differential diagnosis and prognosis in cirrhotic patients with AKI. The aim of the current work is to evaluate urinary Neutrophil Gelatinase-Associated Lipocalin (uNGAL) as a diagnostic biomarker for different causes of acute kidney injury in liver cirrhosis and to assess it as a prognostic marker...
July 2018: Annals of Hepatology
https://www.readbyqxmd.com/read/29893696/new-insights-about-albumin-and-liver-disease
#2
Joana R Carvalho, Mariana Verdelho Machado
Decompensated liver cirrhosis has a dismal prognosis, with an overall survival of 2-4 years, which is worse than for many oncological diseases. Albumin is an important tool in the management of patients with cirrhosis, since it decreases for less than half the risk for post-paracentesis cardiocirculatory dysfunction and mortality associated with spontaneous bacterial infection, as well as, it triplicates the response to terlipressin in patients with hepatorenal syndrome. Recently, research on albumin has been a hot topic, with important new insights such as the characterization of the pleiotropic effects of albumin (which surpass its oncotic properties) and the concept of effective albumin concentration...
July 2018: Annals of Hepatology
https://www.readbyqxmd.com/read/29887344/relative-adrenal-insufficiency-in-cirrhotic-patients-with-ascites-hepatoadrenal-syndrome
#3
Rajiv Ranjan Singh, Rama Walia, Naresh Sachdeva, Ashish Bhalla, Akash Singh, Virendra Singh
AIM: Relative adrenal insufficiency (RAI) has been reported in critically ill patients with cirrhosis. We evaluated the prevalence of RAI and its relationship to clinical course in non-septic cirrhosis patients with ascites. METHODS: The study included 66 consecutive non-septic cirrhosis patients with ascites. RAI was defined by a delta cortisol lower than 9 μg/dL and/or a peak cortisol lower than 18 μg/dL. RESULTS: Sixty-six patients with cirrhosis and ascites were studied...
May 23, 2018: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29845739/hepatorenal-syndrome-in-the-era-of-acute-kidney-injury
#4
Cristina Solé, Elisa Pose, Elsa Solà, Pere Ginès
Acute kidney injury (AKI) is a frequent complication of patients with advanced cirrhosis that it is associated with increased hospital admissions and decreased survival. The definition of AKI in cirrhosis has been recently modified and the new diagnostic criteria are based on small changes of serum creatinine with respect to previous values, occurring within a short period of time. The use of this new definition may lead to an earlier identification of renal impairment and better prognostic stratification. Hepatorenal syndrome (HRS) is a unique form of AKI developing in patients with end-stage liver disease...
May 30, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29760160/development-of-a-novel-clinical-staging-model-for-cirrhosis-using-the-nationwide-inpatient-sample
#5
Mona Haj, Mary Hart, Don C Rockey
Scoring systems such as Model for End-stage Liver Disease (MELD) and Child-Pugh are often used by clinicians to determine prognosis in patients with cirrhosis. Since clinical complications are important in determining cirrhosis outcomes, our goal was to use these to develop a novel prognostic staging model. Data from the Nationwide Inpatient Sample (NIS), years 2003-2011, were queried for records of patients over the age of 18 with cirrhosis excluding patients with prior or inpatient liver transplantation. The primary outcome was inpatient mortality with focus on cirrhosis-related complications: non-bleeding esophageal varices, variceal hemorrhage, ascites, hepatic encephalopathy (HE), spontaneous bacterial peritonitis (SBP), and hepatorenal syndrome (HRS)...
May 14, 2018: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/29743922/xuebijing-injection-combined-with-antibiotics-for-the-treatment-of-spontaneous-bacterial-peritonitis-in-liver-cirrhosis-a-meta-analysis
#6
REVIEW
Dan Han, Ran Wang, Yang Yu, Mingyu Sun, Rolf Teschke, Fernando Gomes Romeiro, Andrea Mancuso, Tingxue Song, Zhong Peng, Bing Han, Xinmiao Zhou, Wenchun Bao, Qianqian Li, Kexin Zheng, Yingying Li, Zhaohui Bai, Xiaozhong Guo, Xingshun Qi
Background and Aim: Spontaneous bacterial peritonitis (SBP) is one of the most common complications of liver cirrhosis. Antibiotics are the main treatment regimen of SBP. Traditional Chinese medicine Xuebijing injection has been used in such patients. Our study aimed to overview the efficacy of Xuebijing injection combined with antibiotics for the treatment of SBP. Method: We searched the PubMed, Embase, China National Knowledge Infrastructure, VIP, and Wanfang databases...
2018: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/29700095/management-of-decompensated-cirrhosis
#7
Dina Mansour, Stuart McPherson
Decompensated cirrhosis is a common reason for admission to the acute medical unit, and such patients typically have complex medical needs and are at high risk of in-hospital death. It is therefore vital that these patients receive appropriate investigations and management as early as possible in their patient journey. Typical presenting clinical features include jaundice, ascites, hepatic encephalopathy, hepato-renal syndrome or variceal haemorrhage. A careful history, examination and investigations can help identify the precipitating cause (infections, gastrointestinal bleeding, high alcohol intake / alcohol-related hepatitis or drug-induced liver injury), so appropriate treatment can be given...
April 1, 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29697689/-aspects-of-the-importance-of-postoperative-hepatoprotector-therapy-in-urgent-surgery
#8
A V Fedoseev, S U Muraviev, V N Budarev, A S Inutin, P S Filonenko, S N Lebedev
The purpose of this study was to determine the effect on the effectiveness of the correction of enteric insufficiency syndrome in patients with urgent surgical pathology included in the scheme of complex therapy Remaxol. The results of complex therapy of 227 patients (98 people with common peritonitis and 129 patients with acute intestinal obstruction) were analyzed. 128 patients of the main group in the postoperative period were included in the therapy scheme Remaxol: intravenously drip in a daily dose of 400 ml at a rate of 40 drops per minute, a course of -5 days...
2018: Khirurgiia
https://www.readbyqxmd.com/read/29686909/spontaneous-bacterial-peritonitis-due-to-lactobacillus-paracasei-in-cirrhosis
#9
Emily Harding-Theobald, Bharat Maraj
Lactobacillus species colonize the human gastrointestinal tract and are rarely pathogenic. We present a case involving a cirrhotic patient who presented with sepsis and was found to have peritoneal cultures demonstrating Lactobacillus as the sole pathogen concerning for spontaneous bacterial peritonitis. Treatment was achieved with high-dose penicillin and clindamycin but the patient developed hepatorenal syndrome and died from acute renal failure. Intra-abdominal Lactobacillus infections are typically seen in patients undergoing peritoneal dialysis or who have recently had bowel perforation...
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29684461/when-should-we-stop-treatment-with-terlipressin-and-albumin-for-patients-with-hepatorenal-syndrome
#10
EDITORIAL
Thomas Reiberger
No abstract text is available yet for this article.
April 21, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29670387/systemic-inflammatory-response-syndrome-and-model-for-end-stage-liver-disease-score-accurately-predict-the-in-hospital-mortality-of-black-african-patients-with-decompensated-cirrhosis-at-initial-hospitalization-a-retrospective-cohort-study
#11
Alassan Kouamé Mahassadi, Justine Laure Konang Nguieguia, Henriette Ya Kissi, Anthony Afum-Adjei Awuah, Aboubacar Demba Bangoura, Stanislas Adjeka Doffou, Alain Koffi Attia
Background: Systemic inflammatory response syndrome (SIRS) and model for end-stage liver disease (MELD) predict short-term mortality in patients with cirrhosis. Prediction of mortality at initial hospitalization is unknown in black African patients with decompensated cirrhosis. Aim: This study aimed to look at the role of MELD score and SIRS as the predictors of morbidity and mortality at initial hospitalization. Patients and methods: In this retrospective cohort study, we enrolled 159 patients with cirrhosis (median age: 49 years, 70...
2018: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29668606/terlipressin-in-the-treatment-of-hepatorenal-syndrome-a-systematic-review-and-meta-analysis
#12
REVIEW
Haiqing Wang, Aixiang Liu, Wentao Bo, Xielin Feng, Yong Hu
BACKGROUND: Hepatorenal syndrome is a fatal complication of advanced cirrhosis. Terlipressin is the most widely used treatment method, however, the therapy effects remain inconsonant. We aim to systematically assess the safety and efficacy of terlipressin for hepatorenal syndrome. METHODS: We conducted a systematic review and meta-analysis. Randomized controlled trials involving terlipressin for hepatorenal syndrome were included in a systematic literature search...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29661461/urgent-living-donor-liver-transplantation-in-a-patient-with-concurrent-active-tuberculosis-a-case-report
#13
B-H Jung, J-I Park, S-G Lee
BACKGROUND: Although active tuberculosis (TB) is considered a contraindication for liver transplantation (LT), this is the only treatment in patients with liver failure and concurrent active TB. We report a case with successful urgent living-donor LT for irreversible liver failure in the presence of active TB. CASE PRESENTATION: A 48-year-old man, with a history of decompensated alcoholic liver cirrhosis, was presented with stupor. At admission, his consciousness had deteriorated to semi-coma, and his renal function also rapidly deteriorated to hepatorenal syndrome...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29658815/oxidative-stress-nox-l-arginine-ratio-and-glutathione-glutathione-s-transferase-ratio-as-predictors-of-sterile-inflammation-in-patients-with-alcoholic-cirrhosis-and-hepatorenal-syndrome-type-ii
#14
Vanja P Nickovic, Dijana Miric, Bojana Kisic, Hristina Kocic, Marko Stojanovic, Salvatore Buttice, Gordana Kocic
Continuous intake of alcohol leads to liver cirrhosis because of imbalance of oxidative stress/antioxidative defense and chronic 'sterile inflammation'. Hepatorenal syndrome (HRS) is the most severe complication of liver cirrhosis. The aim of our study was to assess: (1) the oxidative stress/antioxidative defense markers such as malondialdehyde (MDA), oxidative glutathione (GSH) and glutathione S-transferase (GST), (2) inflammation [C-reactive protein (CRP)], and (3) nitrate/nitrite levels (NOx) and its substrate L-arginine level...
November 2018: Renal Failure
https://www.readbyqxmd.com/read/29652753/hybrid-extracorporeal-therapies-as-a-bridge-to-pediatric-liver-transplantation
#15
Ayse Akcan Arikan, Poyyapakkam Srivaths, Ryan W Himes, Naile Tufan Pekkucuksen, Fong Lam, Trung Nguyen, Tamir Miloh, Michael Braun, John Goss, Moreshwar S Desai
OBJECTIVES: Standard intensive care treatment is inadequate to keep children with liver failure alive without catastrophic complications to ensure successful transplant, as accumulation of endogenous protein-bound toxins often lead to hepatic encephalopathy, hepatorenal syndrome, cardiovascular instability, and multiple organ failure. Given paucity of proven treatment modalities for liver failure, blood purification using different extracorporeal treatments as a bridge to transplantation is used, but studies evaluating the safety and efficacy of combination of these therapies, especially in pediatric liver failure, are lacking...
April 12, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29643536/-genetic-diagnosis-of-caroli-syndrome-with-autosomal-recessive-polycystic-kidney-disease-a-case-report-and-literature-review
#16
X Y Yang, L P Zhu, X Q Liu, C Y Zhang, Y Yao, Y Wu
This case report is about one genetically specified diagnosed infant case of Caroli syndrome with autosomal recessive polycystic kidney disease (ARPKD) in China. The patient in this case report was an eight-month infant boy with an atypical onset and the main clinical manifestation was non-symptomatic enlargement of the liver and kidneys. The imaging study demonstrated a diffused cystic dilatation of intrahepatic bile ducts as well as polycystic changes in bilateral kidneys. The basic blood biochemical tests indicated a normal hepatorenal function...
April 18, 2018: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/29579867/multicentric-study-of-the-andalusian-experience-in-polycystic-liver-disease-as-indication-for-liver-transplantation
#17
S Dios-Barbeito, M Domínguez-Bastante, A Moreno-Navas, F J León-Díaz, Y Fundora-Suárez, F J Briceño-Delgado, M Pitarch-Martínez, M Á Gómez-Bravo
BACKGROUND: The purpose of this study was to determine the morbidity and survival in patients with polycystic liver disease (PLD) undergoing liver transplantation (LT) in 4 Spanish hospitals. METHODS: A multicentric retrospective study using a prospective database was designed including 19 LTs after PLD diagnosis performed from January 1, 1990, to December 31, 2016. Pediatric patients were excluded from the analysis. RESULTS: Of the included patients, 63...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29532591/un-precipitated-acute-kidney-injury-is-uncommon-among-stable-patients-with-cirrhosis-and-ascites
#18
Florence Wong, Peter Jepsen, Hugh Watson, Hendrik Vilstrup
BACKGROUND & AIMS: Acute episodes of renal dysfunction or acute kidney injury (AKI) in cirrhotic patients with ascites are mostly precipitated by an acute event. The prevalence of un-precipitated AKI in stable ascitic cirrhotic patients is unknown. The aims of this study were to determine (i) the prevalence of un-precipitated AKI in stable cirrhotics with ascites and (ii) any predictive factors for its development. METHODS: A total of 1115 stable cirrhotic patients with mild liver and renal dysfunction but varying degrees of ascites severity from 3 previous satavaptan vs placebo randomized controlled trials (Group A, ascites requiring diuretics but not paracentesis; Group B, ascites requiring frequent paracentesis; Group C, refractory ascites) were included...
March 13, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29530803/development-of-an-automated-phenotyping-algorithm-for-hepatorenal-syndrome
#19
Jejo D Koola, Sharon E Davis, Omar Al-Nimri, Sharidan K Parr, Daniel Fabbri, Bradley A Malin, Samuel B Ho, Michael E Matheny
OBJECTIVE: Hepatorenal Syndrome (HRS) is a devastating form of acute kidney injury (AKI) in advanced liver disease patients with high morbidity and mortality, but phenotyping algorithms have not yet been developed using large electronic health record (EHR) databases. We evaluated and compared multiple phenotyping methods to achieve an accurate algorithm for HRS identification. MATERIALS AND METHODS: A national retrospective cohort of patients with cirrhosis and AKI admitted to 124 Veterans Affairs hospitals was assembled from electronic health record data collected from 2005 to 2013...
April 2018: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/29528017/budd-chiari-syndrome-diagnosed-in-a-patient-listed-for-liver-transplant-and-considered-to-be-contraindicated-for-the-operation
#20
Kakharman Yesmembetov, Zhansaya Muratova, Sergey Borovskiy, Irina Ten, Kulpash Kaliaskarova
We report the clinical case of 23-year-old patient with liver cirrhosis of unknown genesis, significant resistant ascites, and 2 episodes of bleeding from esophageal varices. Evaluation did not find any cause of liver disease, and the patient was placed on the transplant wait list due to subcompensated liver function (Model for End-Stage Liver Disease score of 16, Child-Pugh class B) and poorly controlled severe portal hypertension. After treatment with diuretics, largevolume paracentesis, antibiotics, and vasoconstrictors, hepatorenal syndrome and spontaneous bacterial peritonitis resolved and liver function improved significantly...
March 2018: Experimental and Clinical Transplantation
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