Evolution of diagnostic criteria for acute kidney injury in patients with decompensated cirrhosis: A prospective study in a tertiary university hospital

Publication date: Available online 16 August 2019Source: Clinics and Research in Hepatology and GastroenterologyAuthor(s): Nayana Fonseca Vaz, Vanessa Nogueira Rodrigues da Cunha, Marlone Cunha-Silva, Tiago Sevá-Pereira, Jazon Romilson de Souza Almeida, Daniel F. MazoSummaryBackgroundRecently, changes in acute kidney injury (AKI) diagnostic criteria have been proposed (ICA-AKI criteria). However, in Brazil there is a paucity of data and analyses that evaluate AKI in patients with cirrhosis and determine the impact of the implemented AKI criteria changes. Therefore, this study sought to evaluate the incidence of AKI in patients with cirrhosis; to evaluate the agreement between traditional and ICA-AKI criteria; and to assess its clinical and laboratory characteristics, etiologies, risk factors and outcomes.MethodsThis is a prospective cohort study in hospitalized patients with cirrhosis and acute decompensation. The total number of hospitalizations was evaluated using the PWP statistical model for recurring events; P values  1,5 mg/dL remained an important prognostic factor.
Source: Clinics and Research in Hepatology and Gastroenterology - Category: Gastroenterology Source Type: research

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The objective of the current analyses was to characterize the pharmacokinetics (PK) of GLE/PIB in HCV-infected Japanese patients. Data from 332 subjects enrolled in 2 Japan phase 3 trials, CERTAIN-1 and CERTAIN-2, were used in the analyses. Pharmacokinetics of GLE/PIB were characterized using a nonlinear mixed-effects modeling. The analyses evaluated the impact of covariates (concomitant medications and demographic and clinical covariates such as renal impairment, effect of cirrhotic status) on GLE/PIB PK. GLE and PIB PK were described by 1- and 2-compartment models, respectively. Presence of cirrhosis, age, and body weigh...
Source: The Journal of Clinical Pharmacology - Category: Drugs & Pharmacology Authors: Tags: J Clin Pharmacol Source Type: research
AbstractPurposeTo evaluate the feasibility of intraoperative continuous renal replacement therapy (IoCRRT) during liver transplantation (LT), in terms of recruitment, protocol adherence, and ascertainment of follow-up.MethodsIn this pilot randomized open-label controlled trial in adults receiving LT with a Model for End-Stage Liver Disease (MELD) score ≥ 25 and preoperative acute kidney injury (RIFLE - RISK or higher) and/or estimated glomerular filtration rate
Source: Canadian Journal of Anesthesia - Category: Anesthesiology Source Type: research
Ascites occurs in up to 70% of patients during the natural history of cirrhosis. Management of uncomplicated ascites includes sodium restriction and diuretic therapy, whereas that for refractory ascites (RA) is regular large-volume paracentesis with transjugular intrahepatic portosystemic shunt being offered in appropriate patients. Renal impairment occurs in up to 50% of patients with RA with type 1 hepatorenal syndrome (HRS) being most severe. Liver transplant remains the definitive treatment of eligible candidates with HRS, whereas combined liver and kidney transplant should be considered in patients requiring dialysis ...
Source: Clinics in Liver Disease - Category: Gastroenterology Authors: Source Type: research
SM Abstract PURPOSE: To evaluate the feasibility of intraoperative continuous renal replacement therapy (IoCRRT) during liver transplantation (LT), in terms of recruitment, protocol adherence, and ascertainment of follow-up. METHODS: In this pilot randomized open-label controlled trial in adults receiving LT with a Model for End-Stage Liver Disease (MELD) score ≥ 25 and preoperative acute kidney injury (RIFLE - RISK or higher) and/or estimated glomerular filtration rate
Source: Canadian Journal of Anaesthesia - Category: Anesthesiology Authors: Tags: Can J Anaesth Source Type: research
Abstract Chronic kidney disease (CKD) is one of the most important noncommunicable diseases. Abnormal concentration of some tumor markers were found in a spectrum of nonmalignant diseases such as benign ovarian tumors, breast diseases, chronic hepatitis, cirrhosis, diseases of the bile duct, and in CKD. Hence, the present study was undertaken to evaluate carbohydrate antigen (CA) 15-3, carcinoembryonic antigen (CEA), CA 19-9, and human chorionic gonadotropin (HCG) concentrations in advanced stages of CKD (Stage 4 and 5) patients who are not on dialysis and with no known malignancy. Patients included 40 CKD patient...
Source: Saudi Journal of Kidney Diseases and Transplantation - Category: Urology & Nephrology Authors: Tags: Saudi J Kidney Dis Transpl Source Type: research
Hepatitis C virus (HCV) infection is a global health challenge with an estimated 71 million individuals infected worldwide.[1] The disease burden of HCV infection is due to progression of chronic liver disease, which can lead to cirrhosis, liver failure, hepatocellular carcinoma, and death. Chronic HCV infection is also independently associated with the development of renal impairment referred to as chronic kidney disease (CKD) and has been shown to be more prevalent in patients with renal disease.
Source: Journal of Hepatology - Category: Gastroenterology Authors: Source Type: research
Hepatitis C virus (HCV) infection is a global health challenge with an estimated 71 million individuals infected worldwide.1 The disease burden of HCV infection is due to progression of chronic liver disease, which can lead to cirrhosis, liver failure, hepatocellular carcinoma, and death. Chronic HCV infection is also independently associated with the development of renal impairment referred to as chronic kidney disease (CKD) and has been shown to be more prevalent in patients with renal disease.
Source: Journal of Hepatology - Category: Gastroenterology Authors: Tags: Research Article Source Type: research
Euni Lee Unlike chyloperitoneum associated with clinical conditions including cancer, cirrhosis, and traumatic surgery, calcium channel blocker (CCB)-associated chyloperitoneum is rarely discussed in comprehensive studies on chyloperitoneum. We aimed to investigate the prevalence and characteristics of CCB-associated chyloperitoneum in peritoneal dialysis (PD) patients. The MEDLINE, Embase, CENTRAL, CiNii, and RISS databases were systematically searched for clinical studies on CCB-associated chyloperitoneum in PD patients published up to 31 July 2018. A total of 17 studies (four cohort studies, one case series, and ...
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Review Source Type: research
CONCLUSION: HRS is associated with poor outcomes and high hospital costs. Analysis of HRS cost drivers demonstrated an unmet need for additional treatment options to improve outcomes in this patient population. PMID: 30724682 [PubMed - as supplied by publisher]
Source: Journal of Medical Economics - Category: Health Management Tags: J Med Econ Source Type: research
Publication date: February 2019Source: Journal of Vascular and Interventional Radiology, Volume 30, Issue 2Author(s): Michael W. Rowley, Sumit Agarwal, Anil B. Seetharam, Kevin S. HirschAbstractPurposeTo evaluate the rate and risk factors for hemorrhage in patients undergoing real-time, ultrasound-guided paracentesis by radiologists without correction of coagulopathy.Materials and MethodsThis was a retrospective study of all patients who underwent real-time, ultrasound-guided paracentesis at a single institution over a 2-year period. In total, 3116 paracentesis procedures were performed: 757 (24%) inpatients and 2,359 (76%...
Source: Journal of Vascular and Interventional Radiology - Category: Radiology Source Type: research
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