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Acute kidney injury liver cirrhosis

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https://www.readbyqxmd.com/read/29786044/prognostic-value-of-model-for-end-stage-liver-disease-incorporating-with-serum-sodium-score-for-development-of-acute-kidney-injury-after-liver-transplantation
#1
Yuan Cheng, Guo-Qing Wei, Qiu-Cheng Cai, Yi Jiang, Ai-Ping Wu
Background: Contribution of model for end-stage liver disease incorporating with serum sodium (MELD-Na) score in predicting acute kidney injury (AKI) after orthotopic liver transplantation (OLT) is yet to be identified. This study assessed the prognostic value of MELD-Na score for the development of AKI following OLT. Methods: Preoperative and surgery-related variables of 321 adult end-stage liver disease patients who underwent OLT in Fuzhou General Hospital were collected...
June 5, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29784944/value-of-urinary-kim-1-and-ngal-combined-with-serum-cys-c-for-predicting-acute-kidney-injury-secondary-to-decompensated-cirrhosis
#2
Lei Lei, Liang Ping Li, Zhen Zeng, Jing Xi Mu, Xue Yang, Chao Zhou, Zhi Lan Wang, Hu Zhang
Urinary kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and serum cystatin C (Cys C) are biomarkers of acute kidney injury (AKI). However, the efficacy of combining these indices to diagnose decompensated cirrhosis is unknown. This study involved 150 patients divided into AKI and non-AKI, and healthy individuals. Urinary KIM-1 and NGAL, serum Cys and creatine, and glomerular filtration rate (GFR) were compared based on Child-Pugh liver function class. Urinary KIM-1 and NGAL concentrations and serum Cys C levels were significantly higher in patients with AKI secondary to decompensated cirrhosis than in those with AKI not secondary to decompensated cirrhosis (p < 0...
May 21, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29735786/prognostic-significance-of-the-new-criteria-for-acute-kidney-injury-in-cirrhosis
#3
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)...
April 9, 2018: Annals of Hepatology
https://www.readbyqxmd.com/read/29731657/prediction-of-acute-kidney-injury-in-cirrhotic-patients-a-new-score-combining-renal-liver-and-inflammatory-markers
#4
Joana Gameiro, José Agapito Fonseca, Joana Monteiro Dias, Maria João Melo, Sofia Jorge, José Velosa, José António Lopes
Introduction: Acute kidney injury (AKI) is common in hospitalized patients with cirrhosis and is associated with poor prognosis. A risk prediction score combining values easily measured at admission could be valuable to stratify patients for prevention, monitoring and early intervention, ultimately improving patient care and outcomes. The aim of this study was to develop a risk score for AKI in a cohort of cirrhotic patients. Patients and methods: We cross-examined the data from a retrospective analysis of 186 patients with cirrhosis admitted to the Gastroenterology and Hepatology Service of Centro Hospitalar Lisboa Norte from January 2003 to December 2005...
2018: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/29698588/-normal-creatinine-levels-predict-persistent-kidney-injury-and-waitlist-mortality-in-outpatients-with-cirrhosis
#5
Giuseppe Cullaro, Meyeon Park, Jennifer C Lai
Acute kidney injury (AKI) is a critical determinant of outcomes in hospitalized patients with cirrhosis, but little is known of the impact of AKI in the outpatient setting. We analyzed 385 adult outpatients with cirrhosis listed for liver transplant at a single center; excluded were those with severe hepatic encephalopathy, hepatocellular carcinoma or on hemodialysis. Baseline serum creatinine (bCr) was defined as the lowest value recorded; peak creatinine (pCr) as the highest value; delta creatinine (ΔCr) as pCr minus bCr; AKI as a rise in sCR by ≥0...
April 26, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29675988/dose-dependent-impact-of-proton-pump-inhibitors-on-the-clinical-course-of-spontaneous-bacterial-peritonitis
#6
Tammo L Tergast, Anika Wranke, Hans Laser, Svetlana Gerbel, Michael P Manns, Markus Cornberg, Benjamin Maasoumy
BACKGROUND & AIMS: Spontaneous bacterial peritonitis (SBP) is a severe complication in patients with liver cirrhosis leading to acute kidney injury (AKI), hepatic encephalopathy (HE) and a high mortality. In this study we aimed to investigate the impact of proton pump inhibitors (PPI) and the potential relevance of the taken dosage on the incidence and clinical course of SBP. METHODS: Overall, 613 consecutive patients with decompensated liver cirrhosis were included...
April 19, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29599836/acute-kidney-injury-following-the-first-stage-of-the-alpps-procedure-a-case-report
#7
Weijie Tao, Xiaoju Shi, Guangyi Wang
Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a novel approach for performing liver resection, and the number of clinical applications of this technique has rapidly increased within recent years. ALPPS is important in patients who have insufficient residual liver volume and cannot undergo radical hepatic resection. The most common postoperative complications of ALPPS include biliary fistula and infection. To date, postoperative acute kidney injury following ALPPS has not been reported...
March 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29532591/un-precipitated-acute-kidney-injury-is-uncommon-among-stable-patients-with-cirrhosis-and-ascites
#8
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
#9
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/29457046/acute-on-chronic-liver-failure-a-portuguese-single-center-reference-review
#10
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
#11
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/29404491/remodeling-the-model-for-end-stage-liver-disease-for-predicting-mortality-risk-in-critically-ill-patients-with-cirrhosis-and-acute-kidney-injury
#12
Xiao-Dong Zhou, Qin-Fen Chen, Dan-Qin Sun, Chen-Fei Zheng, Dong-Jie Liang, Jian Zhou, Song-Jie Wang, Wen-Yue Liu, Sven Van Poucke, Xiao-Dong Wang, Ke-Qing Shi, Wei-Jian Huang, Ming-Hua Zheng
Serum creatinine measurement demonstrates a poor specificity and sensitivity for the early diagnosis of acute kidney injury (AKI) in patients with cirrhosis. The existing model for end-stage liver disease (MELD) score reveals multiple pitfalls in critically ill patients with cirrhosis and acute kidney injury (CAKI). The aim of this study was to re-evaluate the role of creatinine values in the existing MELD score and to develop a novel score for CAKI, named the "acute kidney injury-model for end-stage liver disease score" (AKI-MELD score)...
October 2017: Hepatology communications
https://www.readbyqxmd.com/read/29382434/diclofenac-acetaminophen-combination-induced-acute-kidney-injury-in-postoperative-pain-relief
#13
Yan Zhu, Ping Xu, Qing Wang, Jian-Quan Luo, Yi-Wen Xiao, Yi-Yi Li, Yan-Gang Zhou, Andrew Cave, Hoan Linh Banh
PURPOSE: The objective of this study was to determine: 1) the incidence and the risk factors of diclofenac/acetaminophen combination as a single agent induced Acute Kidney Injury (AKI) in postoperative pain relief 2) the average cost and length of hospital stay for patients in AKI group and non-AKI group. METHODS: All patients with no prior history of chronic kidney disease (CKD) and normal serum creatinine [44~130 μmol /l] who received diclofenac and acetaminophen combination as a single agent intramuscularly (IM) between January and December 2015 in The Second Xiangya Hospital, Changsha, Hunan, China were included in this retrospective own-control study...
2018: Journal of Pharmacy & Pharmaceutical Sciences: a Publication of the Canadian Society for Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29356707/outcomes-of-simultaneous-liver-kidney-transplantation-implications-for-patient-selection
#14
Lafaine Grant, Shannan Tujios, Amit G Singal
PURPOSE OF REVIEW: Rates of simultaneous liver kidney (SLK) transplantation have continued to increase despite lack of clear allocation guidelines and outcomes data. The organ procurement and transplantation network (OPTN)/UNOS board approved a new SLK allocation policy to standardize medical eligibility and optimize organ utilization. This review highlights the rationale behind these new selection criteria and posttransplant outcomes in various patient populations. RECENT FINDINGS: Uniform criteria for SLK transplantation were adopted in August 2017 and state SLK should be reserved for select patients with cirrhosis who have chronic kidney disease for longer than 3 months, sustained acute kidney injury, or particular metabolic diseases...
April 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29303765/circulating-mir-21-mir-210-and-mir-146a-as-potential-biomarkers-to-differentiate-acute-tubular-necrosis-from-hepatorenal-syndrome-in-patients-with-liver-cirrhosis-a-pilot-study
#15
Mona Mohamed Watany, Rasha Youssef Hagag, Hanaa Ibrahim Okda
BACKGROUND: Acute kidney injury (AKI) in cirrhotic patients may be functional (hepatorenal syndrome [HRS]) or structural (acute tubular necrosis [ATN]). The differentiation between these two conditions remains challenging; no definite biomarker with a clear cutoff value had been declared. miRNAs seem to be attractive innovative biomarkers to identify the nature of kidney injury in cirrhotic patients. This study aimed to investigate the possibility of using miR-21, miR-210 and miR-146a as differentiating markers between HRS and ATN...
April 25, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/29224053/spontaneous-bacteremia-and-spontaneous-bacterial-peritonitis-share-similar-prognosis-in-patients-with-cirrhosis-a-cohort-study
#16
Sebastián Marciano, Melisa Dirchwolf, Carla S Bermudez, Natalia Sobenko, Leila Haddad, Federico Genre Bert, Laura Barcán, Astrid Smud, Maria Lourdes Posadas-Martínez, Diego Giunta, Adrián Gadano
BACKGROUND AND AIMS: Spontaneous bacteremia is a poorly characterized infection in patients with cirrhosis. We compared the incidence of mortality and acute kidney injury in patients with spontaneous bacterial peritonitis and spontaneous bacteremia, and identified risk factors for mortality and acute kidney injury in patients with spontaneous bacteremia. METHODS: We performed a retrospective cohort study of patients with cirrhosis and spontaneous bacteremia or spontaneous bacterial peritonitis from 2008 to 2016 at Hospital Italiano, Buenos Aires...
December 9, 2017: Hepatology International
https://www.readbyqxmd.com/read/29023314/renal-dysfunction-and-cirrhosis
#17
François Durand, Jody C Olson, Mitra K Nadim
PURPOSE OF REVIEW: Hepatorenal syndrome (HRS) does not represent the predominant phenotype of acute kidney injury (AKI) in cirrhosis. Early recognition of HRS helps initiate appropriate therapy. The aims of this review are to present redefinition of AKI, to list new biomarkers, to report recent data on vasopressors in HRS and to propose criteria for simultaneous liver and kidney transplantation (SLKT). RECENT FINDINGS: Urine output, which was not part of the definition of AKI might be reconsidered as it has an independent prognostic value...
December 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28994122/beta-blockers-in-hospitalised-patients-with-cirrhosis-and-ascites-mortality-and-factors-determining-discontinuation-and-reinitiation
#18
MULTICENTER STUDY
A Q Bhutta, G Garcia-Tsao, K R Reddy, P Tandon, F Wong, J G O'Leary, C Acharya, D Banerjee, J G Abraldes, T M Jones, J Shaw, Y Deng, M Ciarleglio, J S Bajaj
BACKGROUND: It has been suggested that beta-blockers may increase mortality in patients with cirrhosis and refractory ascites but the effect of beta-blockers discontinuation or reinitiation has not been examined. AIMS: To compare, in hospitalised patients with cirrhosis and ascites, the effect of BB on survival and to examine the effect/predictors of beta-blockers discontinuation and reinitiation. METHODS: Sub-analysis of NACSELD (North American consortium for the study of end-stage liver disease, database containing prospective data on hospitalised patients with cirrhosis) data from 7 centres enrolling >100 patients with ascites...
January 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28873373/biomarkers-of-renal-injury-in-cirrhosis-association-with-acute-kidney-injury-and-recovery-after-liver-transplantation
#19
Ashwani K Singal, Bradford Jackson, Glauber B Pereira, Kirk B Russ, Paul Stephen Fitzmorris, Donny Kakati, Page Axley, Sujan Ravi, Toni Seay, Satish P Ramachandra Rao, Ravindra Mehta, Yong-Fang Kuo, Karan P Singh, Anupam Agarwal
BACKGROUND: To define urine or serum biomarkers in predicting renal function recovery after liver transplantation (LT). METHODS: Adults listed for LT (February 2011-July 2014) and with modified diet for renal disease-6 (MDRD-6) <60 mL/min provided urine/blood samples at baseline and serially until LT for biomarkers in serum (pg/mL) and urine (pg/mg creatinine). RESULTS: Of 271 LT listed patients (mean age 57 years, 63% males, median listing MELD 17...
2018: Nephron
https://www.readbyqxmd.com/read/28844314/acute-kidney-injury-in-acute-on-chronic-liver-failure-where-does-hepatorenal-syndrome-fit
#20
REVIEW
Andrew Davenport, Mohammed Faisal Sheikh, Edmund Lamb, Banwari Agarwal, Rajiv Jalan
Renal dysfunction occurs in 25% to 50% of patients with cirrhosis admitted to the hospital with an acute episode of hepatic decompensation and may be due to underlying chronic kidney disease, an acute deterioration, or both. An acute deterioration in renal function in cirrhotic patients is now collectively referred to as acute kidney injury (AKI), which has been subclassified into different grades of severity that identify prognostic groups. Acute-on-chronic liver failure is characterized by acute hepatic and/or extrahepatic organ failure driven by a dysregulated immune response and systemic inflammatory response...
November 2017: Kidney International
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