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Hyponatremia Cirrhosis

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https://www.readbyqxmd.com/read/28125428/falls-in-patients-with-liver-cirrhosis
#1
Meric Yildirim
Health-related quality of life (HRQOL) has become an important outcome for patients with liver cirrhosis as the number of transplantation candidates increases by the progression of treatment strategies. Falls and fall-related injuries are common in patients with liver cirrhosis and negatively affect HRQOL. Many factors increase the risk for falls such as minimal hepatic encephalopathy, psychoactive drugs, muscle strength, autonomic dysfunction, hyponatremia, and sleep problems. It is important to understand the underlying mechanisms for falls in cirrhotic patients to prevent severe injuries such as fractures, decrease healthcare costs, and improve HRQOL...
January 24, 2017: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
https://www.readbyqxmd.com/read/28051801/utility-and-safety-of-tolvaptan-in-cirrhotic-patients-with-hyponatremia-a-prospective-cohort-study
#2
MULTICENTER STUDY
Ji-Dong Jia, Wen Xie, Hui-Guo Ding, Hua Mao, Hui Guo, Yonggang Li, Xiaojin Wang, Jie-Fei Wang, Wei Lu, Cheng-Zhong Li, Yimin Mao, Gui-Qiang Wang, Yue-Qiu Gao, Bangmao Wang, Qin Zhang, Yan Ge, Vincent Wai-Sun Wong
Introduction and aim. Hyponatremia is common in patients with decompensated cirrhosis and is associated with increased mortality. Tolvaptan, a vasopressor V2 receptor antagonist, can increase free water excretion, but its efficacy and safety in cirrhotic patients remain unclear. MATERIAL AND METHODS: We studied the usage and safety of tolvaptan in cirrhotic patients in a real-life, non-randomized, multicenter prospective cohort study. Forty-nine cirrhotic patients with hyponatremia were treated with tolvaptan 15 mg daily, and 48 patients not treated with tolvaptan in the same period served as controls...
January 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28002032/hyponatremia-unfavourable-prognostic-factor-in-hepatic-cirrhosis
#3
Aurelia Enescu, F Petrescu, P Mitruţ, V Pădureanu, Octavia Ileana Petrescu, Valeria Carmen Albu, Andreea Larisa Moraru, Anca Ştefania Enescu
Hyponatremia is defined by a level of Na in serum below or equal to 136 mEq/L while in hepatic cirrhosis it is classically considered as relevant only at a level of Na below 130 mEq/L. Hyponatremia frequently occurs in patients with end-stage hepatic disease. The frequency and severity are variable but it has been estimated that it occurs with a frequency of 57% in hospitalized patients with cirrhosis and in those on waiting lists for hepatic transplants. Signs and symptoms of hyponatremia are related to dysfunctions of the central nervous system, due to migration of the water from intravascular space to the brain cells, resulting in the occurrence of cerebral edema...
December 1, 2016: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
https://www.readbyqxmd.com/read/27987289/cryptococcemia-in-an-hiv-negative-patient-with-decompensated-liver-cirrhosis
#4
Manasa Kandula, Amar H Kelkar, Nicole Liberio, Meenakshy K Aiyer
BACKGROUND: Cryptococcal infections have been mostly associated with immunocompromised individuals, 80-90% of whom have been HIV-positive patients. Increasingly, cryptococcal infections are being reported in cirrhotic patients who are HIV-negative. The underlying immunologic defects in cirrhotic patients seem to play an important role in predisposing them to cryptococcosis and affecting their morbidity and mortality. CASE PRESENTATION: We present a case of disseminated cryptococcosis in an HIV-negative patient with underlying cirrhosis, who had rapid worsening of his hyponatremia with renal failure and was unable to recover, despite aggressive measures...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27935926/hyponatremia-in-patients-with-community-acquired-pneumonia
#5
L Karki, B Thapa, M K Sah
INTRODUCTION: Community acquired pneumonia is one the frequent cause of hospital admissions. Whereas, hyponatremia is a common electrolyte abnormality in hospitalized patients and has been shown to be associated with considerable morbidity and mortality. We aim to studyt the association of hyponatremia with community acquired pneumonia in terms of morbidity and mortality. METHODS: A prospective observational hospital based study was conducted in a hospital for a year...
April 2016: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/27801493/hyponatremia-in-cirrhosis-risk-factors-and-prognostic-value
#6
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
https://www.readbyqxmd.com/read/27746291/limited-efficacy-of-tolvaptan-in-patients-with-cirrhosis-and-severe-hyponatremia-real-life-experience
#7
Elisa Pose, Elsa Solà, Salvatore Piano, Elisabetta Gola, Isabel Graupera, Mónica Guevara, Andrés Cárdenas, Paolo Angeli, Pere Ginès
BACKGROUND: Vaptans, vasopressin selective V2-receptor antagonists, represent the first pharmacologic approach to the treatment of hypervolemic hyponatremia in cirrhosis. However, information on the use of vaptans for patients with cirrhosis and hyponatremia in a real-life scenario is limited. Therefore, this study evaluated the effect of tolvaptan on serum sodium in patients with cirrhosis and severe hypervolemic hyponatremia. METHODS: Nine patients with cirrhosis and serum sodium ≤125 mEq/L were included...
March 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/27586252/terlipressin-a-vasoactive-prodrug-recommended-in-hepatorenal-syndrome-is-an-agonist-of-human-v1-v2-and-v1b-receptors-implications-for-its-safety-profile
#8
Pascal H Colson, Anne Virsolvy, Philippe Gaudard, Azzouz Charrabi, Maithé Corbani, Maxime J Manière, Sylvain Richard, Gilles Guillon
Terlipressin is recommended as a gold standard to treat hepatorenal syndrome complicating liver cirrhosis. It is presented as a specific V1A receptor agonist, beyond its enzymatic conversion into lysine(8)-Vasopressin (LVP), able to counteract the splanchnic vasodilation. However, the complete pharmacological characterization of this drug with respect to the different vasopressin receptor subtypes is missing. We studied terlipressin intrinsic properties, focusing not only on V1A, but also on other vasopressin receptor subtypes...
August 29, 2016: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/27571467/-ascites-and-acute-kidney-injury
#9
Salvatore Piano, Marta Tonon, Paolo Angeli
Ascites is the most common complication of cirrhosis. Ascites develops as a consequence of an abnormal splanchnic vasodilation with reduction of effecting circulating volume and activation of endogenous vasoconstrictors system causing salt and water retention. Patients with ascites have a high risk to develop further complications of cirrhosis such as hyponatremia, spontaneous bacterial peritonitis and acute kidney injury resulting in a poor survival. In recent years, new studies helped a better understanding of the pathophysiology of ascites and acute kidney injury in cirrhosis...
July 2016: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/27542610/incidence-of-hyponatremia-with-high-dose-trimethoprim-sulfamethoxazole-exposure
#10
Demetra Tsapepas, Mariana Chiles, Revekka Babayev, Maya K Rao, Manasvi Jaitly, David Salerno, Sumit Mohan
BACKGROUND: Trimethoprim-sulfamethoxazole (TMP-SMX) is a commonly prescribed antibiotic used at high doses for treatment of pneumocystis pneumonia and other infections. Trimethoprim is structurally related to the potassium-sparing diuretic amiloride and has been associated with hyperkalemia and hyponatremia through blocking of epithelial sodium channels in the distal nephron. The incidence of hyponatremia in hospitalized patients treated with high-dose TMP-SMX is unknown. METHODS: We performed a single-center retrospective chart review of all hospitalized patients who received high-dose TMP-SMX (n = 235) from January 2012 to July 2014...
December 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/27405984/potential-effectiveness-of-tolvaptan-to-improve-ascites-unresponsive-to-standard-diuretics-and-overall-survival-in-patients-with-decompensated-liver-cirrhosis
#11
Tomoharu Yamada, Takamasa Ohki, Yuki Hayata, Yuki Karasawa, Satoshi Kawamura, Daisaku Ito, Kentaro Kojima, Michiharu Seki, Nobuo Toda, Kazumi Tagawa
BACKGROUND AND OBJECTIVE: After tolvaptan was approved for the treatment of cirrhosis patients with ascites, only a few studies have reported its efficacy in the real clinical setting, and no studies have reported its contribution to overall survival. This study clarified the clinical outcomes of tolvaptan treatment in terms of improving ascites unresponsive to standard diuretics (AUS) and overall survival. METHODS: We retrospectively enrolled 80 decompensated cirrhosis patients with AUS who were administered tolvaptan from October 2012 to December 2014...
October 2016: Clinical Drug Investigation
https://www.readbyqxmd.com/read/27399058/wernicke-encephalopathy-in-a-patient-with-liver-failure-clinical-case-report
#12
Pan Zhao, Yanling Zhao, Zhenman Wei, Jing Chen, Lilong Yan
Early recognition and diagnosis of Wernicke encephalopathy is pivotal for the prognosis of this medical emergency, especially in patients with liver failure which predisposes individuals to develop hepatic encephalopathy. For these patients, distinguishing between hepatic encephalopathy and Wernicke encephalopathy is a challenge in real-world clinical practice.A male patient with 21-year medical history of liver cirrhosis presented diarrhea and ascites. One month before this visit, he was noted to have poor appetite and progressive fatigue...
July 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27363974/treatment-for-cirrhotic-ascites
#13
REVIEW
Hideto Kawaratani, Hiroshi Fukui, Hitoshi Yoshiji
Common complications of decompensated liver cirrhosis are esophageal varices, hepatic encephalopathy and ascites. After the onset of complications, the prognosis worsens. In patients with ascites, the 5-year mortality rate is 44%. Furthermore, hyponatremia, spontaneous bacterial translocation and hepatorenal syndrome also greatly worsen the prognosis. Effective treatment of cirrhotic ascites improves the quality of life and survival rate. Recently, the newly produced diuretic, tolvaptan (vasopressin V2 receptor antagonist), was reported to be effective in the treatment of refractory ascites in liver cirrhosis; however, there has not been an associated positive effect on the prognosis...
July 1, 2016: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/27362549/influence-of-preoperative-sodium-concentration-on-outcome-of-patients-with-hepatitis-b-virus-cirrhosis-after-liver-transplantation
#14
Peijie Wang, Gang Huang, Ngalei Tam, Chenglin Wu, Shunjun Fu, Bridget P Hughes, Linwei Wu, Xiaoshun He
OBJECTIVES: Whether preoperative serum sodium concentration could influence post-transplant patients' prognosis remains controversial. The aim of this study was to evaluate the influence of patients' pretransplant sodium concentration on the prognosis after liver transplantation in a cohort of patients with hepatitis B virus-related cirrhosis. PATIENTS AND METHODS: Data derived from the Chinese Liver Transplantation Registry system from 1 January 2000 to 31 December 2011 were extracted...
October 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27353278/factors-contributing-to-the-development-of-overt-encephalopathy-in-liver-cirrhosis-patients
#15
Motoh Iwasa, Ryosuke Sugimoto, Rumi Mifuji-Moroka, Nagisa Hara, Kyoko Yoshikawa, Hideaki Tanaka, Akiko Eguchi, Norihiko Yamamoto, Kazushi Sugimoto, Yoshinao Kobayashi, Hiroshi Hasegawa, Yoshiyuki Takei
The aim of this study was to clarify the relationships among psychometric testing results, blood ammonia (NH3) levels, electrolyte abnormalities, and degree of inflammation, and their associations with the development of overt hepatic encephalopathy (HE) in liver cirrhosis (LC) patients. The relationships between covert HE and blood NH3, sodium (Na), and C-reactive protein (CRP) were examined in 40 LC patients. The effects of elevated NH3, hyponatremia, and elevated CRP on the development of overt HE were also investigated...
October 2016: Metabolic Brain Disease
https://www.readbyqxmd.com/read/27328847/hyponatremia-in-patients-with-liver-diseases-not-just-a-cirrhosis-induced-hemodynamic-compromise
#16
REVIEW
G Liamis, T D Filippatos, A Liontos, M S Elisaf
Hyponatremia (Na(+) <135 mmol/l) is the most common electrolyte disorder. Cirrhosis represents a rather frequent cause of hyponatremia mainly due to systemic and splanchnic vasodilation resulting in decreased effective arterial blood volume, which leads to excessive non-osmotic secretion of antidiuretic hormone. However, hyponatremia of multifactorial origin may be seen in patients with liver diseases. The review focuses on the factors and pathogenetic mechanisms of decreased sodium levels other than the hemodynamic compromise of cirrhosis in patients with liver diseases...
September 2016: Hepatology International
https://www.readbyqxmd.com/read/27278239/ascites-in-children
#17
REVIEW
Ashish Bavdekar, Nitin Thakur
Ascites is an accumulation of serous fluid within the peritoneal cavity. It is the most common complication of liver cirrhosis. In children, hepatic, renal and cardiac disorders are the most common causes. Portal hypertension and sodium and fluid retention are key factors in the pathophysiology of ascites. Peripheral arterial vasodilatation hypothesis is the most accepted mechanism for inappropriate sodium retention and formation of ascites. Diagnostic paracentesis is indicated in children with newly diagnosed ascites and in children with suspected complications of ascites...
November 2016: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/27188289/tyrosinemia-type-1-and-irreversible-neurologic-crisis-after-one-month-discontinuation-of-nitisone
#18
Neslihan Önenli Mungan, Dinçer Yıldızdaş, Deniz Kör, Özden Özgür Horoz, Faruk İncecik, Murat Öktem, Johannes Sander
Tyrosinemia type I is an autosomal recessively inherited metabolic disease of tyrosine metabolism due to the deficiency of fumarylacetoacetate hydrolase. Clinical manifestations include hepatic failure, cirrhosis, hepatocellular carcinoma, renal fanconi syndrome, and neurologic crisis. With the introduction of 2-(2-nitro-4-trifluoro-methylbenzyol)-1,3 cyclohexanedione treatment the prognosis improved with reduced rate of complications. "Neurologic crisis" of tyrosinemia type I is a rare complication seen after discontinuation of treatment characterized with anorexia, vomiting, and hyponatremia in the initial phase continuing with paresthesia and paralysis of the extremities and the diaphragm...
October 2016: Metabolic Brain Disease
https://www.readbyqxmd.com/read/27149296/insufficient-evidence-of-benefit-regarding-mortality-due-to-albumin-substitution-in-hcc-free-cirrhotic-patients-undergoing-large-volume-paracentesis
#19
F Kütting, J Schubert, J Franklin, A Bowe, V Hoffmann, M Demir, A Pelc, D Nierhoff, U Töex, H M Steffen
BACKGROUND: Current guidelines for clinical practice recommend the infusion of human albumin after large volume paracentesis. After inspecting the current evidence behind this recommendation, we decided to conduct a systematic review and meta-analysis in order to address the effect of albumin on mortality and morbidity in the context of large volume paracentesis. METHODS: We performed a comprehensive search of large databases and abstract books of conference proceedings up to March 15th 2016 for randomized controlled trials, testing the infusion of human albumin against alternatives (vs...
May 3, 2016: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27037930/the-changing-role-of-sodium-management-in-cirrhosis
#20
REVIEW
Blanca Lizaola, Alan Bonder, Elliot B Tapper, Angela Mendez-Bocanegra, Andres Cardenas
Hyponatremia may occur in patients with cirrhosis and ascites mainly due to water retention and an inability of the kidney to excrete free water. The main reason for this abnormality is related to the fact that these patients have portal hypertension and this leads to systemic vasodilation that in turn activates sodium-retaining and water-retaining systems such as the renin-angiotensin-aldosterone system and arginine vasopressin (AVP). AVP increases solute-free water retention by acting on the V2 receptors of the kidney-collecting tubes...
June 2016: Current Treatment Options in Gastroenterology
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