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acute kidney failure cirrhosis

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https://www.readbyqxmd.com/read/30076614/terlipressin-is-superior-to-noradrenaline-in-the-management-of-acute-kidney-injury-in-acute-on-chronic-liver-failure
#1
Vinod Arora, Rakhi Maiwall, Rajan Vijayaraghavan, Ankur Jindal, Shasthry Saggere Muralikrishna, Guresh Kumar, Priyanka Jain, Shiv Kumar Sarin
BACKGROUND: Hepatorenal syndrome (HRS) carries a high short-term mortality in patients with cirrhosis and ACLF. Terlipressin and noradrenaline are routinely used in cirrhosis with HRS and have been found to be equally effective. There is no data comparing the efficacy of terlipressin with noradrenaline in ACLF patients with HRS. METHODS: In an open-label RCT, consecutive patients with ACLF diagnosed with HRS-AKI, were randomised to albumin with infusion of terlipressin (2-12 mg/d) (n=60) or noradrenaline (0...
August 3, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29953167/interventions-for-chronic-non-hypovolaemic-hypotonic-hyponatraemia
#2
REVIEW
Evi V Nagler, Maria C Haller, Wim Van Biesen, Raymond Vanholder, Jonathan C Craig, Angela C Webster
BACKGROUND: Chronic (present > 48 hours) non-hypovolaemic hyponatraemia occurs frequently, can be caused by various conditions, and is associated with shorter survival and longer hospital stays. Many treatments, such as fluid restriction or vasopressin receptor antagonists can be used to improve the hyponatraemia, but whether that translates into improved patient-important outcomes is less certain. OBJECTIVES: This review aimed to 1) look at the benefits and harms of interventions for chronic non-hypovolaemic hypotonic hyponatraemia when compared with placebo, no treatment or head-to-head; and 2) determine if benefits and harms vary in absolute or relative terms dependent on the specific compound within a drug class, on the dosage used, or the underlying disorder causing the hyponatraemia...
June 28, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29934721/chances-of-renal-recovery-or-liver-transplantation-after-hospitalization-for-alcoholic-liver-disease-requiring-dialysis
#3
Adrienne Lenhart, Salwa Hussain, Reena Salgia
BACKGROUND: Acute kidney injury in the setting of alcoholic liver disease portends a poor prognosis without liver transplant. AIMS: Using a tertiary care population, we aimed to evaluate the outcomes of renal replacement therapy in patients with alcoholic liver disease and acute kidney injury with < 6 months sobriety. METHODS: A retrospective review of hospitalized patients with alcoholic hepatitis/acute on chronic alcoholic cirrhosis and hepatorenal syndrome or acute tubular necrosis was performed...
June 22, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29910108/prevalence-predictors-and-impact-of-bacterial-infection-in-acute-on-chronic-liver-failure-patients
#4
Shalimar, Gyanranjan Rout, Shekhar S Jadaun, Gyan Ranjan, Saurabh Kedia, Deepak Gunjan, Baibaswata Nayak, Subrat Kumar Acharya, Ajay Kumar, Arti Kapil
BACKGROUND: Acute on chronic liver failure (ACLF) is associated with high short term mortality. We aimed to evaluate the prevalence, predictors and impact of bacterial infection in ACLF. METHODS: Consecutive hospitalized patients with cirrhosis and acute decompensation (AD), from January 2011-March 2017, were included. Predictors of survival and infection were assessed. RESULTS: 572 patients with cirrhosis and AD were classified into 3 groups - no infection (group 1, n = 190, 33...
May 28, 2018: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29881239/acute-kidney-injury-in-acute-on-chronic-liver-failure-is-different-from-in-decompensated-cirrhosis
#5
Qun-Qun Jiang, Mei-Fang Han, Ke Ma, Guang Chen, Xiao-Yang Wan, Semvua Bukheti Kilonzo, Wen-Yu Wu, Yong-Li Wang, Jie You, Qin Ning
AIM: To evaluate the differences in acute kidney injury (AKI) between acute-on-chronic liver failure (ACLF) and decompensated cirrhosis (DC) patients. METHODS: During the period from December 2015 to July 2017, 280 patients with hepatitis B virus (HBV)-related ACLF (HBV-ACLF) and 132 patients with HBV-related DC (HBV-DC) who were admitted to our center were recruited consecutively into an observational study. Urine specimens were collected from all subjects and the levels of five urinary tubular injury biomarkers were detected,including neutrophil gelatinase-associated lipocalin (NGAL), interleukin-18 (IL-18), liver-type fatty acid binding protein (L-FABP), cystatin C (CysC), and kidney injury molecule-1 (KIM-1)...
June 7, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29851765/-acute-variceal-bleeding-causes-significant-morbidity
#6
Marta Carneiro de Moura, Shiyi Chen, Binita M Kamath, Vicky Lee Ng, Simon C Ling
BACKGROUND AND AIMS: The need for primary prophylaxis of variceal bleeding in children is unclear due to insufficient evidence of the efficacy of prophylactic therapy and the mortality and morbidity associated with the first bleeding event. Previous studies have provided estimates of mortality. We aimed to investigate the morbidity associated with acute variceal bleeding (AVB) in children and to identify contributing factors. METHODS: We retrospectively reviewed children with chronic liver disease or portal vein thrombosis admitted with acute upper gastrointestinal bleeding between 2000 and 2015...
May 30, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29739707/non-alcoholic-fatty-liver-disease-and-increased-risk-of-all-cause-mortality-in-elderly-patients-admitted-for-acute-heart-failure
#7
Filippo Valbusa, Davide Agnoletti, Luca Scala, Cristina Grillo, Pietro Arduini, Stefano Bonapace, Stefano Calabria, Giuliana Scaturro, Alessandro Mantovani, Giacomo Zoppini, Emanuela Turcato, Aldo Pietro Maggioni, Guido Arcaro, Giovanni Targher
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is an emerging risk factor for incident heart failure (HF). It is currently unknown whether NAFLD predicts all-cause mortality in patients admitted for acute HF. We aimed to assess whether NAFLD and its severity (diagnosed by ultrasonography and non-invasive fibrosis biomarkers) were associated with increased all-cause mortality in this particularly high-risk patient population. METHODS: We studied 264 elderly patients, who were consecutively admitted for acute HF to the hospital between years 2013 and 2015, after excluding those with acute myocardial infarction, severe valvular heart diseases, kidney failure, cancer, cirrhosis of any etiology or known chronic liver diseases...
August 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29735786/prognostic-significance-of-the-new-criteria-for-acute-kidney-injury-in-cirrhosis
#8
Emilia T O Bansho, Pedro Eduardo S Silva, Bruno S Colombo, Letícia M Wildner, Maria Luiza Bazzo, Esther B Dantas-Corrêa, Leonardo L Schiavon, Janaína L Narciso-Schiavon
BACKGROUND: New criteria for acute kidney injury (AKI) in cirrhosis have been proposed, but its prognostic significance is unclear. This study aims to evaluate the prognostic significance of the AKI criteria in cirrhotic patients hospitalized for acute decompensation. MATERIAL AND METHODS: This is a prospective cohort study. AKI was defined as an increase in creatinine (Cr) levels ≥ 0.3 mg/dL in 48 h or ≥ 50% of the basal value in the last 7d. AKI was divided into stages 1 (elevation: &lt; 2x basal), 2 (2 or 3x), and 3 (&gt; 3x)...
May 2018: Annals of Hepatology
https://www.readbyqxmd.com/read/29689120/acute-on-chronic-liver-failure-getting-ready-for-prime-time
#9
Jasmohan S Bajaj, Richard Moreau, Patrick S Kamath, Hugo E Vargas, Vicente Arroyo, K Rajender Reddy, Gyongyi Szabo, Puneeta Tandon, Jody Olson, Constantine Karvellas, Thierry Gustot, Jennifer C Lai, Florence Wong
Acute on chronic liver failure (ACLF) is a culmination of chronic liver disease and extra-hepatic organ failures, which is associated with a high short-term mortality and immense healthcare expenditure. There are varying definitions for organ failures and ACLF in Europe, North America and Asia. These differing definitions need to be reconciled to enhance progress in the field. The pathogenesis of ACLF is multi-factorial and related to interactions between the immuno-inflammatory system, microbiota and the precipitating factors...
April 24, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29579889/retransplant-due-to-fulminant-hepatic-failure-from-hepatitis-e-virus-a-case-report
#10
E Tenorio González, M Robles Díaz, R Sanjuan Jiménez, R González Grande, R V Olmedo Martín, J M Rodrigo López, M Jiménez Pérez
Hepatitis E virus (HEV) usually causes self-limiting acute liver infections from fecal or oral transmission, though other routes of infection exist (vertical transmission, blood transfusion, zoonosis). It may give rise to fulminant hepatic failure in 1% of cases. Cases have recently been reported of chronic infection evolving to cirrhosis in immunosuppressed patients, such as those with a liver or kidney transplant. Nonetheless, development of acute liver failure in these patients is exceptional, with few cases published...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29480417/mortality-from-spontaneous-bacterial-peritonitis-among-hospitalized-patients-in-the-usa
#11
Bolin Niu, Brian Kim, Berkeley N Limketkai, Jing Sun, Zhiping Li, Tinsay Woreta, Po-Hung Chen
BACKGROUND AND AIM: Spontaneous bacterial peritonitis (SBP) is a serious complication of cirrhosis and is associated with significant morbidity and mortality. In this study, we examined the clinical characteristics and risk factors associated with mortality in hospitalized patients presenting with SBP. METHODS: The Nationwide Inpatient Sample was queried for all hospitalizations involving SBP from 2006 to 2014 using the International Classification of Disease-9-CM Code...
May 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29457046/acute-on-chronic-liver-failure-a-portuguese-single-center-reference-review
#12
Miguel Verdelho, Rui Perdigoto, João Machado, Élia Mateus, Paulo Marcelino, Rui Pereira, Philip Fortuna, Luís Bagulho, Luís Bento, Francisco Ribeiro, Fernando Nolasco, Américo Martins, Eduardo Barroso
Acute-on-chronic liver failure (ACLF) is a syndrome characterized by an acute deterioration of a patient with cirrhosis, frequently associated with multi-organ failure and a high short-term mortality rate. We present a retrospective study that aims to characterize the presentation, evolution, and outcome of patients diagnosed with ACLF at our center over the last 3 years, with a comparative analysis between the group of patients that had ACLF precipitated by infectious insults of bacterial origin and the group of those with ACLF triggered by a nonbacterial infectious insult; the incidence of acute kidney injury and its impact on the prognosis of ACLF was also analyzed...
January 2018: GE Portuguese Journal of Gastroenterology
https://www.readbyqxmd.com/read/29427501/infections-complicating-cirrhosis
#13
REVIEW
Salvatore Piano, Alessandra Brocca, Sara Mareso, Paolo Angeli
Patients with cirrhosis have a high risk of bacterial infections. Bacterial infections induce systemic inflammation that may lead to organ failure and acute-on-chronic liver failure (ACLF) resulting in a high risk of short term mortality. The early diagnosis and treatment of bacterial infections is essential to improve the patient's prognosis. However, in recent years, the spread of multidrug resistant (MDR) bacterial infections has reduced the efficacy of commonly used antibiotics such as third generation cephalosporins...
February 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29361652/proposed-diagnostic-criteria-for-acute-on-chronic-liver-failure-in-japan
#14
Satoshi Mochida, Nobuaki Nakayama, Akio Ido, Kazuaki Inoue, Takuya Genda, Yasuhiro Takikawa, Isao Sakaida, Shuji Terai, Osamu Yokosuka, Masahito Shimizu, Hajime Takikawa
To establish diagnostic criteria for acute-on-chronic liver failure (ACLF) in Japan, the Intractable Hepato-Biliary Disease Study Group of Japan undertook a multicenter pilot survey for patients fulfilling the Asian Pacific Association for the Study of the Liver (APASL), Association for the Study of the Liver-Chronic Liver Failure (EASL-Clif) Consortium, or Chinese Medical Association (CMA) diagnostic criteria for ACLF. The APASL criteria were suitable for screening Japanese patients with ACLF when patients whose conditions were triggered by gastrointestinal bleeding were included within the disease entity, and the EASL-Clif Consortium criteria were useful for classifying the severity of the patients' conditions...
March 2018: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/29240010/well-preserved-renal-function-in-children-with-untreated-chronic-liver-disease
#15
Ulla B Berg, Antal Németh
OBJECTIVES: On the basis of studies with hepatorenal syndrome, it is widely regarded that renal function is impacted in chronic liver disease (CLD). Therefore, we investigated renal function in children with CLD. METHODS: In a retrospective study of 277 children with CLD, 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...
April 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29234197/echocardiographic-and-electrocardiographic-predictors-of-adverse-outcomes-in-spontaneous-bacterial-peritonitis
#16
Mahek Shah, Soumya Patnaik, Obiora Maludum, Shantanu Patil, Toni Anne De Venecia, Vincent M Figueredo
Background: Patients with cirrhosis who develop Spontaneous Bacterial Peritonitis (SBP) suffer from cirrhotic cardiomyopathy which is characterized by impaired contractility in response to stress despite a relatively normal resting cardiac output. We hypothesized that electrocardiographic and echocardiographic information would help prognosticate patients developing SBP in addition to existing scoring systems. Methods: Cirrhotic patients admitted to Einstein Medical Center from 01/01/2005 to 6/30/2012 for SBP, and did not receive a transplant within one year, were included...
December 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29148856/novel-applications-for-serum-procalcitonin-testing-in-clinical-practice
#17
Justin J Choi, Matthew W McCarthy
Procalcitonin has emerged as a reliable marker of acute bacterial infection in hospitalized patients and the assay has recently been incorporated into several clinical algorithms to reduce antimicrobial overuse, but its use in patients with end-organ dysfunction is controversial. Areas covered: In this review, the authors examine what is known about procalcitonin testing in patients with organ dysfunction, including those with end-stage renal disease, congestive heart failure, chronic obstructive pulmonary disease, and cirrhosis, and explore how the assay is now being used in the management of non-infectious diseases...
January 2018: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/28953954/epidemiological-clinical-diagnostic-and-economic-features-of-an-immigrant-population-of-chronic-schistosomiasis-sufferers-with-long-term-residence-in-a-non-endemic-country-north-metropolitan-area-of-barcelona-2002-2016
#18
Sílvia Roure, Lluís Valerio, Olga Pérez-Quílez, Gema Fernández-Rivas, Octavio Martínez-Cuevas, Albert Alcántara-Román, Diego Viasus, M Luisa Pedro-Botet, Miquel Sabrià, Bonaventura Clotet
BACKGROUND: Schistosomiasis, one of the neglected tropical diseases (NTD) listed by the WHO, is an acute and chronic parasitic disease caused by blood flukes (trematode worms) of the genus Schistosoma. Complications of long-term infestation include liver cirrhosis, bladder tumors and kidney failure. The objective of this study was to carry out a clinical and epidemiological characterization of a schistosomiasis-diagnosed immigrant population with long-term residencein the EU as well as to evaluate the diagnostic methods available to date...
2017: PloS One
https://www.readbyqxmd.com/read/28919595/a-case-of-hepatorenal-syndrome-and-abdominal-compartment-syndrome-with-high-renal-congestion
#19
Hiroteru Kamimura, Takayuki Watanabe, Tomoyuki Sugano, Nao Nakajima, Junji Yokoyama, Kenya Kamimura, Atsunori Tsuchiya, Masaaki Takamura, Hirokazu Kawai, Takashi Kato, Gen Watanabe, Satoshi Yamagiwa, Shuji Terai
BACKGROUND Hepatorenal syndrome (HRS) is a reversible renal impairment that occurs in patients with acute liver failure and advanced liver cirrhosis. HRS is due to a renal vasoconstriction that results from extreme vasodilatation. It is therefore a functional disorder, not associated with structural kidney damage. On the other hand, end-stage liver diseases are often complicated by massive ascites. Massive ascites may cause abdominal compartment syndrome (ACS), which includes impairment of renal blood flow, but there are no reports indicating that kidney lesions caused by ACS may pathologically contribute to end-stage liver diseases...
September 18, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28913043/wilson-s-disease-presenting-with-hellp-syndrome-a-case-report
#20
Sümeyra Nergiz Avcıoğlu, Sündüz Özlem Altınkaya, Mert Küçük, Emre Zafer, Selda Demircan Sezer, Ali Rıza Odabaşı
Wilson's disease (WD) is an autosomal recessive disorder. It is characterized by toxic accumulation of copper mainly in the liver and brain but also in cornea and kidney due to a defect in biliary excretion of copper. The hepatic manifestation of WD is diverse and may include asymptomatic elevation of aminotransferase, chronic hepatitis, cirrhosis, or acute/fulminant hepatic failure. Characteristic of acute hepatic failure in WD is concomitance of acute intravascular hemolytic anemia. Acute intravascular hemolytic anemia and thrombocytopenia in WD may be interpreted as a feature of Hemolysis, Elevated Liver Enzymes, Low Platelet Count (HELLP) syndrome besides acute liver failure...
March 2015: Turkish Journal of Obstetrics and Gynecology
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