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Hepatorenal syndrome

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https://www.readbyqxmd.com/read/28176190/relative-adrenal-insufficiency-in-patients-with-cirrhosis-a-systematic-review-and-meta-analysis
#1
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...
February 7, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28151755/renal-cystic-disease-and-associated-ciliopathies
#2
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...
February 1, 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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28052382/systematic-review-with-meta-analysis-vasoactive-drugs-for-the-treatment-of-hepatorenal-syndrome-type-1
#7
REVIEW
F J Gifford, J R Morling, J A Fallowfield
BACKGROUND: Hepatorenal syndrome type 1 (HRS1) is a functional, rapidly progressive, potentially reversible form of acute kidney injury occurring in patients with cirrhosis. Characterised by intense renal arterial vasoconstriction, it carries a very poor prognosis. There is a significant unmet need for a widely approved, safe and effective pharmacological treatment. AIM: To re-evaluate efficacy and safety of pharmacological treatments for HRS1, in the light of recently published randomised controlled trials (RCTs)...
March 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28029746/respiratory-manifestations-in-38-patients-with-alstr%C3%A3-m-syndrome
#8
Caroline Boerwinkle, Jan D Marshall, Joy Bryant, William A Gahl, Kenneth N Olivier, Meral Gunay-Aygun
OBJECTIVES: Alström syndrome (AS) is a rare, multi-system condition characterized by retinal degeneration, sensorineural hearing loss, obesity, insulin-resistant diabetes, hypertriglyceridemia, cardiomyopathy, hepatorenal disease, and recurrent respiratory infections. It belongs to a group of genetic disorders known as primary ciliopathies, which includes autosomal dominant and recessive polycystic kidney diseases, as well as Joubert and Bardet-Biedl syndromes. Prior studies have suggested phenotypic overlap between primary ciliopathies affecting the non-motile, sensory cilia, and primary ciliary dyskinesia (PCD), a motile ciliopathy characterized by respiratory tract disease...
December 28, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28013112/urine-interleukin-18-and-lipocalin-2-are-biomarkers-of-acute-tubular-necrosis-in-patients-with-cirrhosis-a-systematic-review-and-meta-analysis
#9
Jeremy Puthumana, Xavier Ariza, Justin M Belcher, Isabel Graupera, Pere Ginès, Chirag R Parikh
BACKGROUND & AIMS: Acute kidney injury (AKI) is a common complication in patients with cirrhosis that increases mortality. The most common causes of AKI in these patients are prerenal azotemia, acute tubular necrosis (ATN), and hepatorenal syndrome; it is important to determine the etiology of AKI to select the proper treatment and predict patient outcome. Urine biomarkers could be used to differentiate between patients with ATN and functional causes of AKI. We performed a systemic review and meta-analysis of published studies to determine whether urine levels of interleukin 18 (IL18) and lipocalin 2 (LCN2 or NGAL) associate with development of ATN in patients with cirrhosis...
December 21, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28008340/fractional-excretion-of-sodium-in-hepatorenal-syndrome-clinical-and-pathological-correlation
#10
Ali A Alsaad, Hani M Wadei
AIM: To determine the accuracy of fractional excretion of sodium (FeNa) in the diagnosis of hepatorenal syndrome (HRS). METHODS: Eighty-eight liver transplantation candidates with renal dysfunction and/or proteinuria were included in the study sample. The baseline characteristics of the patients were obtained. All the 88 patients underwent iothalamate glomerular filtration rate testing, 24-h urine collection for urinary sodium and protein excretions, random urine for sodium and creatinine testing, and percutaneous kidney biopsy...
December 8, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/28003716/pharmacologic-treatment-of-alcoholic-hepatitis-examining-outcomes-based-on-disease-severity-stratification
#11
Ryan E Owens, Heather S Snyder, Jennifer D Twilla, Sanjaya K Satapathy
OBJECTIVES: Maddrey discriminant function (MDF) score is a measure of disease prognosis in alcoholic hepatitis (AH) used to identify patients at highest risk of mortality and determine the need for initiation of pharmacologic treatment. The purpose of this study was to evaluate the effects of pharmacologic therapy for hospitalized AH patients as stratified by MDF score. METHODS: A retrospective review of patients with an AH diagnosis admitted to a Methodist LeBonheur Healthcare adult hospital between 06/2009 and 06/2014 was conducted...
December 2016: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/27987536/acute-kidney-injury-in-liver-cirrhosis-new-definition-and-application
#12
REVIEW
Florence Wong
The traditional diagnostic criteria of renal dysfunction in cirrhosis are a 50% increase in serum creatinine (SCr) with a final value above 1.5 mg/dL. This means that patients with milder degrees of renal dysfunction are not being diagnosed, and therefore not offered timely treatment. The International Ascites Club in 2015 adapted the term acute kidney injury (AKI) to represent acute renal dysfunction in cirrhosis, and defined it by an increase in SCr of 0.3 mg/dL (26.4 µmoL/L) in <48 hours, or a 50% increase in SCr from a baseline within ≤3 months...
December 2016: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/27984174/emergency-tips-in-a-child-pugh-b-patient-when-does-the-window-of-opportunity-open-and-close
#13
REVIEW
Jonel Trebicka
Transjugular intrahepatic portosystemic shunt (TIPS) is used to treat complications of cirrhosis such as variceal bleeding and refractory ascites, but it also bears the risk of liver failure, overt hepatic encephalopathy (HE) and cardiac decompensation. Variceal bleeding may be controlled using endoscopic and medical treatment in patients with compensated cirrhosis; in decompensated patients, however, TIPS improves survival. Therefore, an early TIPS (within 72h or if later, still early after bleeding) might improve the survival of patients by preventing an inflammatory response and bacterial translocation...
October 29, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27938570/-advances-in-diagnosis-and-treatment-of-acute-kidney-injury-in-patients-with-liver-cirrhosis
#14
J Chen, S H Gao
Since the 21st century, nephrology and emergency and critical care medicine have proposed the concept of acute kidney injury (AKI), and its core lies in early diagnosis and early treatment to improve prognosis. The concept of AKI has also been used in the diagnosis and treatment of kidney injury in patients with liver cirrhosis. AKI is one of the common complications in patients with decompensated liver cirrhosis, and AKI has unique features in patients with liver cirrhosis. AKI greatly affects the prognosis of patients with liver cirrhosis and increases hospitalization rate and medical burden...
October 20, 2016: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/27920543/intestinal-permeability-in-a-patient-with-liver-cirrhosis
#15
REVIEW
Jonathan Manuel Aguirre Valadez, Liliana Rivera-Espinosa, Osvely Méndez-Guerrero, Juan Luis Chávez-Pacheco, Ignacio García Juárez, Aldo Torre
Liver cirrhosis is a worldwide public health problem, and patients with this disease are at high risk of developing complications, bacterial translocation from the intestinal lumen to the mesenteric nodes, and systemic circulation, resulting in the development of severe complications related to high mortality rate. The intestinal barrier is a structure with a physical and biochemical activity to maintain balance between the external environment, including bacteria and their products, and the internal environment...
2016: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/27876501/serum-and-urinary-biomarkers-that-predict-hepatorenal-syndrome-in-patients-with-advanced-cirrhosis
#16
Desmond Y H Yap, Wai Kay Seto, James Fung, Siu Ho Chok, See Ching Chan, Gary C W Chan, Man Fung Yuen, Tak Mao Chan
BACKGROUND: Prediction of hepatorenal syndrome (HRS) remains difficult in advanced cirrhotic patients. AIMS: To evaluate use of serum and urine biomarkers to predict HRS. METHODS: We prospectively recruited Child's B or C cirrhotic patients with normal serum creatinine, and followed them for 12 weeks for the development of HRS. Serum Cystatin C (CysC), serum and urine Neutrophil Gelatinase-Associated Lipocalin (NGAL), serum and urine IL-18, serum N-acetyl-β-d glucosaminidase (NAG), urine kidney injury molecule-1 (KIM-1) and urine liver-type fatty acid binding protein (LFABP) were measured at recruitment (baseline), and their relationship with subsequent HRS investigated...
February 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/27871159/-acute-kidney-injury-in-cirrhotic-patients-with-portal-hypertension
#17
REVIEW
So Mi Kim, Il Han Song
Acute kidney injury (AKI) is one of the most common manifestations encountered in clinical practice. It is associated with high morbidity and mortality in cirrhotic pre- and post-transplantation patients. Hepatorenal syndrome (HRS), a special form of AKI in cirrhotic patients, was recognized as a consequence of renal vasoconstriction from systemic/renal hemodynamic alterations developed in advanced cirrhosis with portal hypertension. Recently, multiple factors-such as infection/inflammation, underlying glomerulonephritis, bile cast, or increased abdominal pressure-have been considered to contribute to renal dysfunction in cirrhotic patients, which were presumed to induce HRS...
November 25, 2016: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/27850217/577-impact-of-hepatorenal-syndrome-reversal-on-clinical-outcomes-beyond-survival
#18
Khurram Jamil, Ram Subramanian, Stephen Pappas, Stevan Gonzalez, Shannon Escalante
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27843430/cirrhotic-cardiomyopathy-another-case-of-a-successful-approach-to-treatment-of-hepatorenal-syndrome
#19
Luis Otávio Mocarzel, Jessica Bicca, Luiza Jarske, Thamires Oliveira, Pedro Lanzieri, Ronaldo Gismondi, Mario Luiz Ribeiro
Hepatorenal syndrome (HRS) is defined as a failure of renal function, potentially reversible, in patients with liver cirrhosis and ascites. Recently, a component of cardiomyopathy associated with HRS was described, but the use of positive inotropic medicine as part of the treatment of the acute phase has not been extensively evaluated. We report a second case in our hospital of a patient with HRS type I without previous heart disease, with secondary hemodynamic decompensation due to liver disease, in which the abnormalities in systolic function by speckle-tracking echocardiography were observed and could be reversed by the use of inotropes...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27801493/hyponatremia-in-cirrhosis-risk-factors-and-prognostic-value
#20
Rym Ennaifer, Myriam Cheikh, Hayfa Romdhane, Rafika El Elj, Houda Ben Nejma, Wassila Bougassas, Najet Bel Hadj
Background Hyponatremia is the most common electrolyte abnormality encountered in cirrhotic patients. Recent studies have shown that hyponatremia was correlated with severity of cirrhosis and associated with increased risk of complications and mortality. However this relationship is still unclear. The aims of the present study were to search predictive factors for hyponatremia in cirrhosis and to assess its prognostic value. Methods We performed a retrospective study, including consecutive cirrhotic patients admitted to our department between January 2011 and April 2014...
May 2016: La Tunisie Médicale
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