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AKI liver

Kinsuk Chauhan, Yorg Azzi, Geovani Faddoul, Luz Liriano-Ward, Paul Chang, Girish Nadkarni, Veronica Delaney, Scott Ames, Neha Debnath, Nandita Singh, Vinita Sehgal, Graciela Di Boccardo, Felipe Garzon, Vinay Nair, Rebecca Kent, Susan Lerner, Steven Coca, Ron Shapiro, Sander Florman, Thomas Schiano, Madhav C Menon
SLK allocation protocols allocate dual-organs based on a sustained eGFR of 30 ml/min or less. A 2017-UNOS update includes CKD3 as dual organ candidates but only when the listing eGFR is less than 30 ml/min while recommending a "safety net" for prioritized kidney listing post-LT. We retrospectively reviewed adult LTs examine whether the UNOS proposal captured the LT population at highest risk for developing post-LT ESRD. Among 290 LT-recipients, 67 had pre-LT CKD3, 141 had AKI, of whom 47 required dialysis (<4 weeks)...
October 19, 2018: Clinical Transplantation
Benjamin P T Loveday, Martin J Dib, Sangita Sequeira, Nouf Alotaiby, Robin Visser, Andrew S Barbas, Alice C Wei, Sean P Cleary, Carol-Anne Moulton, Steven Gallinger, Paul D Greig, Ian D McGilvray
BACKGROUND: The left renal vein (LRV) may be used for venous reconstruction during hepato-pancreato-biliary (HPB) surgery, although concerns exist about compromising renal function. This study aimed to determine renal outcomes following LRV harvest during HPB resections. METHODS: Circumferential PV/SMV resections from 2008 to 2014 were included within two groups (LRV harvest, Control). Absolute and change in Creatinine (Cr) and estimated GFR (eGFR), and rates of acute kidney injury (AKI) and chronic kidney disease (CKD), were compared...
October 12, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Hajar F Karaali, Ragaee R Fahmi, Jamilah M Borjac
Background Acetaminophen (APAP) is one of the most widely used drugs to treat pain. Its overdose is lethal causing liver and kidney failure. Nephrotoxicity and hepatotoxicity are mostly due to the overproduction of reactive oxygen species. Ocimum basilicum, known as basil, is a commonly used medicinal plant due to its versatile role as antibacterial, antifungal, and anti-oxidative. We aim in this study to investigate the preventive and protective effect of basil leaves aqueous extract against APAP-induced hepatorenal toxicity in BALB/c mice...
October 12, 2018: Journal of Complementary & Integrative Medicine
Lena Sibulesky, Scott W Biggins, Raimund Pichler
Acute kidney injury (AKI) is a frequent postoperative complication after liver transplantation. The etiology is multifactorial, including perioperative renal status, surgery related events, and postoperative immunosuppression therapy. The role of renal hypoperfusion and hepatic ischemia-reperfusion injury as causes of early AKI are now being increasingly recognized. Further studies should focus on therapies that would attenuate this injury.
September 27, 2018: World Journal of Hepatology
Geraldo Bezerra da Silva Junior, Sérgio Luiz Arruda Parente Filho, Douglas de Sousa Soares, Rodrigo da Nóbrega de Alencar, Tiago Tomaz Teles Peixoto, Isadora Sales Nogueira, Antônio Mendes Ponte de Oliveira Filho, Fernanda Holanda Menezes, Malena Gadelha Cavalcante, Roberto da Justa Pires Neto, Elizabeth de Francesco Daher
OBJECTIVE: HIV-related mortality is still high, especially in developed countries. The aim of this study is to investigate factors associated to death in HIV-infected patients. METHODS: This is a cross-sectional study with all HIV adult patients admitted to a tertiary infectious diseases hospital in Fortaleza, Northeast Brazil, from January 2013 to December 2014. Patients were divided into two groups: survivors and non-survivors. Demo-graphical, clinical and laboratory data were compared and a logistic regression was performed in order to investigate risk factors for death...
June 2018: Revista da Associação Médica Brasileira
William Beaubien-Souligny, Marie-Noëlle Pépin, Louis Legault, Jean-François Cailhier, Jean Éthier, Louis Bouchard, Bernard Willems, André Y Denault
Rationale: Acute kidney injury (AKI) is a frequent complication after liver transplantation. In some patients, prompt intervention targeted at a specific etiology is of paramount importance. Presenting concerns of the patients: A 25 years old man with advanced liver cirrhosis caused by sclerosing cholangitis and autoimmune hepatitis underwent orthotopic liver transplantation. One month after surgery, severe AKI developed in conjunction with recurrent ascites and lower extremity edema...
2018: Canadian Journal of Kidney Health and Disease
Ying Tang, Shiu-Kwong Mak, An P Xu, Hui-Yao Lan
Acute kidney injury (AKI) is characterized by both non-inflammatory and inflammatory process, and accumulating evidence has demonstrated that inflammation plays a key role in the pathogenesis and progression of AKI. C-reactive protein (CRP), an acute reactant produced by liver and many inflammatory cells, acts not only as an inflammation biomarker, but also as a pathogenic factor for AKI. Indeed, increased concentration of CRP is associated with poor outcome of varied etiologically related AKI patients. In recent years, the role of CRP is gradually recognized as an active participant in the pathogenesis and progression of AKI by exacerbating local inflammation, impairing the proliferation of damaged tubular epithelial cells and promoting fibrosis of injured renal tissue...
October 2018: Nephrology
Arthur C Y Yeung, Andrew Morozov, Francis P Robertson, Barry J Fuller, Brian R Davidson
BACKGROUND: Acute kidney injury (AKI) is common after orthotopic liver transplantation (OLT) usually occurring early post-transplant. Multiple causes include graft preservation injury, blood loss, hypotension but also severity of recipient liver disease. Early intervention in AKI has both short and long term patient benefits. Unfortunately there are no current clinical biomarkers of early AKI. AIM: To assess the value of NGAL in predicting AKI following OLT. METHODS: Ovid MEDLINE and EMBASE were searched between the years of 2000 and 2017 for studies using keywords: Neutrophil Gelatinase Associated Lipocalin or NGAL variants combined with synonyms for liver transplantation...
September 28, 2018: International Journal of Surgery
Li-Li Huang, Rui-Ting Long, Gui-Ping Jiang, Xiao Jiang, Hang Sun, Hui Guo, Xiao-Hui Liao
Mitochondria are the center of energy metabolism in the cell and the preferential target of various toxicants and ischemic injury. Renal ischemia-reperfusion (I/R) injury triggers proximal tubule injury and the mitochondria are believed to be the primary subcellular target of I/R injury. The promotion of mitochondrial biogenesis (MB) is critical for the prevention I/R injury. The results of our previous study showed that augmenter of liver regeneration (ALR) has anti-apoptotic and anti-oxidant functions. However, the modulatory mechanism of ALR remains unclear and warrants further investigation...
December 2018: Apoptosis: An International Journal on Programmed Cell Death
Joanna Baron-Stefaniak, Judith Schiefer, Paul Lichtenegger, Edmund J Miller, Gabriela A Berlakovich, Peter Faybik, David M Baron
BACKGROUND: Elevated concentrations of D-dopachrome tautomerase (D-DT) were associated with adverse outcome in various clinical settings. However, no study assessed D-DT concentrations in patients requiring orthotopic liver transplantation (OLT). The aim of this observational study was to measure serum D-DT concentrations in patients undergoing OLT and associate D-DT with survival and acute kidney injury (AKI). METHODS: Forty-seven adults with end-stage liver disease undergoing OLT were included...
September 22, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Alexsander K. Bressan, Matthew T. James, Elijah Dixon, Oliver F. Bathe, Francis R. Sutherland, Chad G. Ball
Background: Acute kidney injury (AKI) is associated with increased morbidity and mortality after liver resection. Patients with hepatocellular carcinoma (HCC) have a higher risk of AKI owing to the underlying association between hepatic and renal dysfunction. Use of the Acute Kidney Injury Network (AKIN) diagnostic criteria is recommended for patients with cirrhosis, but remains poorly studied following liver resection. We compared the prognostic value of the AKIN creatinine and urine output criteria in terms of postoperative outcomes following liver resection for HCC...
October 1, 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Clement Lo, Tadashi Toyama, Ying Wang, Jin Lin, Yoichiro Hirakawa, Min Jun, Alan Cass, Carmel M Hawley, Helen Pilmore, Sunil V Badve, Vlado Perkovic, Sophia Zoungas
BACKGROUND: Diabetes is the commonest cause of chronic kidney disease (CKD). Both conditions commonly co-exist. Glucometabolic changes and concurrent dialysis in diabetes and CKD make glucose-lowering challenging, increasing the risk of hypoglycaemia. Glucose-lowering agents have been mainly studied in people with near-normal kidney function. It is important to characterise existing knowledge of glucose-lowering agents in CKD to guide treatment. OBJECTIVES: To examine the efficacy and safety of insulin and other pharmacological interventions for lowering glucose levels in people with diabetes and CKD...
September 24, 2018: Cochrane Database of Systematic Reviews
Kimberly C Claeys, Evan J Zasowski, Abdalhamid M Lagnf, Noor Sabagha, Donald P Levine, Susan L Davis, Michael J Rybak
INTRODUCTION: Acute bacterial skin and skin structure infections (ABSSSIs) represent a large burden to the US healthcare system. There is little evidence-based guidance regarding the appropriate level of care for ABSSSIs. This study aimed to develop a prediction model and risk-scoring tool to determine appropriate levels of care. METHODS: This was a single-center observational cohort study of adult patients treated for ABSSSIs from 2012 to 2015 at the Detroit Medical Center...
September 22, 2018: Infectious Diseases and Therapy
Seung Don Baek, Jae-Young Kang, Hoon Yu, Seulgi Shin, Hyang-Sook Park, Mi-Soon Kim, Eun Kyoung Lee, So Mi Kim, Jai Won Chang
BACKGROUND: Evidence suggests that alkaline phosphatase attenuates inflammatory response in sepsis by lipopolysaccharide detoxification and adenosine triphosphate dephosphorylation. We sought to determine changes in alkaline phosphatase (AP) activity during septic acute kidney injury (AKI) and clinical parameters associated with AP activity. METHODS: In this retrospective study, we investigated baseline (when initiating CRRT) and follow-up AP activity on day 3, and associated outcomes in patients who underwent continuous renal replacement therapy (CRRT) due to septic AKI...
September 20, 2018: BMC Nephrology
Jeannette D Widmer, Andrea Schlegel, Mohamed Ghazaly, Brian Richie Davidson, Charles Imber, Dinesh Sharma, Massimo Malago, Joerg-Matthias Pollok
The cava-preserving piggyback technique requires only partial cava clamping during anhepatic phase in liver transplantation (LT) and therefore maintains venous return and may hemodynamically stabilize the recipient. Hence, it is an on-going debate, if piggy-back implantation is more protective from acute kidney injury (AKI) after LT when compared to classic cava replacement technique. The aim of this study was therefore to assess the rate of AKI and other complications after LT comparing both transplant techniques without the use of veno-venous bypass...
September 19, 2018: Liver Transplantation
Pere Ginès, Elsa Solà, Paolo Angeli, Florence Wong, Mitra K Nadim, Patrick S Kamath
Hepatorenal syndrome (HRS) is a form of kidney function impairment that characteristically occurs in cirrhosis. Recent changes in terminology have led to acute HRS being referred to as acute kidney injury (AKI)-HRS and chronic HRS as chronic kidney disease (CKD)-HRS. AKI-HRS is characterized by a severe impairment of kidney function owing to vasoconstriction of the renal arteries in the absence of substantial abnormalities in kidney histology. Pathogenetic mechanisms involve disturbances in circulatory function due to a marked splanchnic arterial vasodilation, which triggers the activation of vasoconstrictor factors...
September 13, 2018: Nature Reviews. Disease Primers
Ryoichi Sugisawa, Ginga Komatsu, Emiri Hiramoto, Naoki Takeda, Ken-Ichi Yamamura, Satoko Arai, Toru Miyazaki
Tissue macrophage-derived apoptosis inhibitor of macrophage (AIM, encoded by cd5l gene) is a circulating protein that has suppressive functions in a broad range of diseases including obesity, liver steatosis, hepatocellular carcinoma (HCC), and acute kidney injury (AKI). In healthy states, high levels of AIM circulate in the inactivated state by associating with the immunoglobulin M (IgM) pentamer in the blood, whereas during AKI, AIM dissociates from IgM and gains disease repair activity. Here, we assessed whether AIM activation via its release from IgM is required to ameliorate other diseases...
September 3, 2018: Scientific Reports
Ryutaro Sakabe, Kenji Shirakawa, Kosuke Yoshimura, Hiroyuki Otsuka, Aki Kuwada, Ko Tahara, Hiroshi Hotei, Yoshiyuki Maeda
We report a case of nephrotic syndrome induced by ramucirumab for metastatic rectal cancer. A 48-year old woman who had received FOLFIRI plus ramucirumab for rectal cancer with liver, lung, and bone metastases presented to our hospital with edema and increased body weight. Laboratory studies showed hypoalbuminemia and severe proteinuria, and the patient was diagnosed with nephrotic syndrome. After administration of an angiotensin II receptor blocker and thiazide diuretic, her symptoms disappeared and serum albumin level normalized...
August 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Ravi Sujan, Monica Cruz-Lemini, Jose Altamirano, Doug Simonetto, Rakhi Maiwall, Page Axley, Taylor Richardson, Vivek Desai, Joaquin Cabezas, Victor Vargas, Patrick S Kamath, Vijay H Shah, Shiv K Sarin, Ramon Bataller, Ashwani K Singal
BACKGROUND AND RATIONALE: Identifying patients at high risk for AKI during hospitalization among patients admitted with severe alcoholic hepatitis (AH0 is an unmet clinical need. METHODS: We performed a multicentric prospective cohort study using data from four different cohorts on well-characterized patients hospitalized with severe AH. RESULTS: Data collected on 773 AH patients from four cohorts across the globe was randomly split into test (n=390) and validation (n=383) cohorts...
August 28, 2018: Liver Transplantation
Moon Young Kim, Yeon Seok Seo
Acute kidney injury (AKI) is common in patients with liver cirrhosis, occurring in 13-20% of patients hospitalized with decompensated cirrhosis, and is significantly associated with the prognosis. The development and progression of AKI is an independent predictive factor for mortality in these patients. If AKI develops, the renal function declines progressively even if AKI is improved later, the patients have a poorer prognosis compared to those who have not developed AKI. In addition, in patients without appropriate treatment or no improvement with the initial treatment, AKI often progress to hepatorenal syndrome (HRS), which is associated with significant morbidity and mortality...
August 25, 2018: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
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