The Liver and Renal Disease
CLINICS IN LIVER DISEASE (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - April 27, 2022 Category: Gastroenterology Authors: David Bernstein Source Type: research
Copyright
Elsevier (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - April 27, 2022 Category: Gastroenterology Source Type: research
Contributors
NORMAN GITLIN, MD, FRCP (LONDON), FRCPE (EDINBURGH), FAASLD, FACP, FACG (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - April 27, 2022 Category: Gastroenterology Source Type: research
Contents
David Bernstein (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - April 27, 2022 Category: Gastroenterology Source Type: research
Forthcoming Issues
Pediatric Liver Disease (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - April 27, 2022 Category: Gastroenterology Source Type: research
Hyponatremia in Cirrhosis
Hyponatremia is the most common electrolyte disorder encountered in clinical practice, and it is a common complication of cirrhosis reflecting an increase in nonosmotic secretion of arginine vasopressin as a result of of the circulatory dysfunction that is characteristic of advanced liver disease. Hyponatremia in cirrhosis has been associated with poor clinical outcomes including increased risk of morbidity and mortality, poor quality of life, and heightened health care utilization. Despite this, the treatment of hyponatremia in cirrhosis remains challenging as conventional therapies such as fluid restriction are frequentl...
Source: Clinics in Liver Disease - April 1, 2022 Category: Gastroenterology Authors: Helbert Rondon-Berrios, Juan Carlos Q. Velez Source Type: research
Hepatorenal Syndrome
Hepatorenal syndrome (HRS) is a hemodynamically driven process mediated by renal dysregulation and inflammatory response. Albumin, antibiotics, and β-blockers are among therapies that have been studied in HRS prevention. There are no Food and Drug Administration–approved treatments for HRS although multiple liver societies have recommended terlipressin as first-line pharmacotherapy. Renal replacement therapy is the primary modality used to b ridge to definitive therapy with orthotopic liver transplant or simultaneous liver-kidney transplant. Advances in our understanding of HRS pathophysiology and emerging therapeutic m...
Source: Clinics in Liver Disease - April 1, 2022 Category: Gastroenterology Authors: Sebastiano Buccheri, Ben L. Da Source Type: research
Kidney Replacement Therapy in Patients with Acute Liver Failure and End-Stage Cirrhosis Awaiting Liver Transplantation
Providing dialysis to patients with liver failure is challenging because of their tenuous hemodynamics and refractory ascites. With better machinery and increased availability, continuous kidney replacement therapy has been successfully delivered to acutely ill patients in liver failure over the past few decades. Intermittent hemodialysis continues to remain the modality of choice outside the intensive care unit and on occasion needs to be complemented with paracentesis. Peritoneal dialysis has not been widely used, but recent literature shows promising outcomes barring for publication bias. Albumin dialysis could be a lif...
Source: Clinics in Liver Disease - April 1, 2022 Category: Gastroenterology Authors: Karthik Kovvuru, Juan Carlos Q. Velez Source Type: research
Kidney Allocation Issues in Liver Transplantation Candidates with Chronic Kidney Disease and Severe Kidney Liver Injury
This article further explores the rationale for and outlines the implementation of the SLK allocation policy. (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - April 1, 2022 Category: Gastroenterology Authors: Daniel Lia, Elliot I. Grodstein Source Type: research
Chronic Kidney Disease After Liver Transplantation
Improved survival after liver transplantation has led to an aging cohort of recipients at risk of renal dysfunction. The etiology of renal dysfunction is typically multifactorial; calcineurin inhibitors nephrotoxicity, pretransplant renal dysfunction, and perioperative acute kidney injury are important risk factors. Metabolic complications such as hypertension, diabetes mellitus, and metabolic-associated fatty liver disease also contribute to the development of renal disease. Most LT recipients will eventually develop some degree of renal dysfunction. Criteria to select candidates for simultaneous liver and kidney transpla...
Source: Clinics in Liver Disease - April 1, 2022 Category: Gastroenterology Authors: Ramon O. Minjares, Paul Martin, Andres F. Carrion Source Type: research
The Interplay Between Nonalcoholic Fatty Liver Disease and Kidney Disease
This article discusses the complex interplay between NAFLD and chronic kidney disease (CKD), as well as the underlying pathogenesis and mechanisms through which NAFLD and CKD are linked. Exploration of these sophisticated relationships and causative factors is essential to accurately assessing kidney function in patients with NAFLD, recommending pharmacologic treatment of disease, and identifying favorable avenues for future investigation. (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - April 1, 2022 Category: Gastroenterology Authors: Emily Truong, Mazen Noureddin Source Type: research
Polycystic Kidney/Liver Disease
Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disorder that leads to chronic kidney disease and end-stage kidney disease (ESKD). Polycystic liver disease (PCLD) is the most common extrarenal manifestation of ADPKD. Though isolated PCLD and PCLD due to ADPKD are genetically distinct, they follow a similar clinical course of hepatomegaly from multiple cysts with preserved liver function. Tolvaptan use in ADPKD can slow down the deterioration of renal function and growth of cysts. Somatostatin analogs can slow the growth of polycystic livers but the effect is short-lived. The only curative therapy for PCLD...
Source: Clinics in Liver Disease - April 1, 2022 Category: Gastroenterology Authors: Rebecca Roediger, Douglas Dieterich, Pramodh Chanumolu, Priya Deshpande Source Type: research
Peritransplant Renal Dysfunction in Liver Transplant Candidates
Renal function is intricately tied to Model for End-Stage Liver Disease score and overall prognosis among patients with cirrhosis. The estimation of glomerular filtration rate (GFR) and etiology of renal impairment are even more magnified among cirrhotic patients in the period surrounding liver transplantation. Novel biomarkers including cystatin C and urinary neutrophil gelatinase-associated lipocalin have been demonstrated to more accurately assess renal dysfunction and aid in the diagnosis of competing etiologies. Accurately identifying the severity and chronicity of renal dysfunction among transplant candidates is an i...
Source: Clinics in Liver Disease - April 1, 2022 Category: Gastroenterology Authors: Rajiv Heda, Alexander J. Kovalic, Sanjaya K. Satapathy Source Type: research
Simultaneous Liver –Kidney Transplantation
End-stage kidney disease (ESKD) after liver transplantation is associated with high morbidity and mortality. This increase in mortality can be offset by performing a kidney transplant at the time of the liver transplant in select cases. Accordingly, Margreiter and colleague; s performed the first simultaneous liver –kidney (SLK) transplant in 1983. The number of SLK transplants has increased by more than 300% since then. In 1990%, 1.7% of all liver transplants in the United States were SLK transplants which increased to 9.9% by 2016. This steep increase was likely due to the implementation of the model of en d-stage live...
Source: Clinics in Liver Disease - April 1, 2022 Category: Gastroenterology Authors: Gayatri Nair, Vinay Nair Source Type: research
The Use of Hepatitis C Virus –Positive Organs in Hepatitis C Virus–Negative Recipients
This article reviews existing experience in liver and kidney transplant. Fifteen studies with 218 HCV D+/R − liver transplants, with 182 from viremic donors, show a sustained viral response for 12 weeks (SVR12) rate of 99.5%. Nine studies involving 204 HCV donor-positive recipient-negative kidney transplant recipients had an SVR12 rate of 99.5%. Complications are infrequent. Preemptive treatment in kid ney transplant of for only 4 weeks or even 4 days showed surprising success rates. (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - April 1, 2022 Category: Gastroenterology Authors: Christian Kuntzen, Zohaib Bagha Source Type: research
