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Diagnostics (Basel) 2022 Jun 8;12(6). Epub 2022 Jun 8.

Biomedical Information Center, Beijing You' An Hospital, Capital Medical University, Beijing 100069, China.

Hepatorenal syndrome (HRS) is a life-threatening complication of cirrhosis with a poor prognosis. To develop novel and effective nomograms which could numerically predict both the hospital survival and transplant-free survival of HRS, we retrospectively enrolled a cohort of 149 patients. A backward stepwise method based on the smallest Akaike information criterion value was applied to select the covariates to be included in the Cox proportional hazards models. Read More

J Trop Pediatr 2022 Jun;68(4)

Division of Pediatric Intensive Care, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey.

Regional citrate anticoagulation (RCA) is an option but citrate accumulation is risk and it is a giving up cause for this situation. This retrospective study was conducted in the pediatric intensive care unit (PICU) between May 2019 and April 2021. We investigated 47 patients with liver failure (LF) in our PICU, and RCA during continuous renal replacement therapy (CRRT) was applied to 10 (21. Read More

BMC Gastroenterol 2022 Jun 20;22(1):299. Epub 2022 Jun 20.

Department of Endoscopy, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, Hiroshima, 734-8553, Japan.

Background: Gastric cancer remains a severe public health problem worldwide, particularly in Japan. Recent studies have demonstrated that serum markers are beneficial for risk stratification in gastric cancer development. We aimed to evaluate the usefulness of serum markers either alone or in combination (serum markers plus endoscopy) for effective risk stratification of gastric cancer development. Read More

Frontline Gastroenterol 2022 2;13(4):295-302. Epub 2021 Jul 2.

Paul L Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA.

Background And Objective: Cirrhosis is the number one cause of non-cancer deaths among gastrointestinal diseases and is responsible for significant morbidity and healthcare utilisation. The objectives were to measure the 30-day readmissions rate following index hospitalisation, to determine the predictors of readmission, and to estimate the cost of 30-day readmission in patients with decompensated cirrhosis.

Methods: We performed a retrospective cohort study of patients with decompensated cirrhosis using 2014 Nationwide Readmission Database from January to November. Read More

Therap Adv Gastroenterol 2022 14;15:17562848221102679. Epub 2022 Jun 14.

Division of Gastroenterology and Hepatology, Department of Medicine, Toronto General Hospital, University Health Network, University of Toronto, 9EN/222 Toronto General Hospital, 200 Elizabeth Street, 9EN222, Toronto, ON M5G2C4, Canada.

Hepatorenal syndrome (HRS) is a serious form of renal dysfunction in patients with cirrhosis and ascites. It is an important component of the acute-on-chronic liver failure (ACLF) syndrome. Significant recent changes in the understanding of the pathophysiology of renal dysfunction in cirrhosis include the role of inflammation in addition to hemodynamic changes. Read More

J Vasc Access 2022 Jun 16:11297298221106102. Epub 2022 Jun 16.

Department of Critical Care Medicine, Higashiosaka City Medical Center, Higashiosaka, Osaka Prefecture, Japan.

A 54-year-old male patient diagnosed with hepatorenal syndrome caused by decompensated alcoholic cirrhosis was referred for arteriovenous fistula (AVF) creation after initiation of hemodialysis. A brachiobasilic arteriovenous fistula (BBAVF) was created because neither forearm had suitable vasculature. Large-volume serous effusion from the incision persisted postoperatively, and we started negative pressure wound therapy (NPWT) for wound protection. Read More

Dis Markers 2022 1;2022:3451544. Epub 2022 Jun 1.

Department of Infectious Disease, Zhejiang Hospital, Hangzhou, China.

Hepatorenal syndrome (HRS) could occur when patients get decompensated liver cirrhosis. Meanwhile, hepatitis B virus (HBV) infection raises the risk of mortality of the end-stage liver diseases. As the artificial liver support system (ALSS) has been applied in liver failure, whether ALSS could benefit HBV-derived HRS remains uncertain. Read More

J Clin Exp Hepatol 2022 May-Jun;12(3):899-907. Epub 2021 Sep 28.

Department of Gastroenterology and Hepatology, Asian Institute of Gastroenterology, Hyderabad, India.

Background: Prerenal acute kidney injury (prerenal AKI), hepatorenal syndrome (HRS-AKI), and acute tubular necrosis (ATN-AKI) are the various phenotypes of acute kidney injury, which are described in decompensated cirrhosis. It has therapeutic and prognostic implications. We aimed to evaluate the diagnostic utility of fractional excretion of sodium and urea (FENa and FEUrea) for differentiating AKI phenotypes. Read More

J Clin Exp Hepatol 2022 May-Jun;12(3):871-875. Epub 2021 Oct 28.

Institute of Digestive Health & Liver Diseases, Mercy Medical Center, Baltimore MD, USA.

Background And Aims: Ascites and hyponatremia are important milestones of worsening portal hypertension in those with cirrhosis. The objective of our study was to evaluate the differences in clinical characteristics, resource utilization, and disposition of hospitalized cirrhotic patients with ascites with and without hyponatremia.

Methods: The National Inpatient Sample (NIS) database was used to identify all adult hospitalized patients with a diagnosis of cirrhosis and ascites with or without hyponatremia from 2016 to 2017 using ICD-10 codes. Read More

J Clin Exp Hepatol 2022 May-Jun;12(3):853-860. Epub 2021 Nov 15.

Department of Cardiology, Sir Ganga Ram Hospital, New Delhi, India.

Background And Aims: Cirrhotic cardiomyopathy (CCM) is a term used to collectively describe abnormal structural and functional changes in heart of patients with cirrhosis. The present study was undertaken to find the prevalence of CCM in patients with liver cirrhosis and its predictors. We also followed these patients to evaluate the role of CCM in the development of hepatorenal syndrome (HRS). Read More

Transplant Proc 2022 Jun 5. Epub 2022 Jun 5.

Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Hospital das Clínicas da Faculdade de Medicina de São Paulo; Laboratory of Medica Investigation 37 (LIM-37), Faculdade de Medicina da Universidade de São Paulo.

Background: Terlipressin is widely used for treatment of hepatorenal syndrome and variceal bleeding in cirrhotic patients. However, it may be associated with side effects, especially those related to vasoconstriction, such as myocardial infarction or intestinal ischemia. This is a case report of a cirrhotic patient with nonvariceal upper gastrointestinal bleeding after duodenal necrosis due to the use of terlipressin, a novel side effect not yet described in literature to the best of our knowledge. Read More

Med Klin Intensivmed Notfmed 2022 Jun 4. Epub 2022 Jun 4.

Klinik für Akut- und Notfallmedizin, St.-Antonius-Hospital gGmbH, Eschweiler, Deutschland.

Liver Transpl 2022 May 28. Epub 2022 May 28.

Clinical Pharmacokinetics Center, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil.

The liver plays a major role in drug metabolism. Liver transplantation impacts the intrinsic metabolic capability and extra-hepatic mechanisms of drug disposition and elimination. Different levels of inflammation and oxidative stress during transplantation, the process of liver regeneration, and the characteristics of the graft alter the amount of functional hepatocytes and liver enzymes activity. Read More

Crit Care Nurs Q 2022 Jul-Sep 01;45(3):258-265

Divisions of Nephrology and Hypertension (Drs Muaddi and Nashar) and Pulmonary, Critical Care Medicine (Drs Muaddi, Ledgerwood, and Dumont and Ms Sheridan), Allegheny Health Network, Pittsburgh, Pennsylvania.

Acute kidney injury or acute renal failure is commonly observed in the critically ill patient with hemodynamic compromise. Dialysis is frequently used in the intensive care units as part of the critical care management of metabolic derangements fluid status and electrolyte issues. It is imperative that the bedside critical care nurse is able to identify acute kidney injury and is familiar with the modalities used to manage the metabolic consequences of renal failure, particularly important as the bedside nurse is operating the continuous renal replacement machine at the bedside. Read More

Am J Transplant 2022 May 26. Epub 2022 May 26.

Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.

When timely access to deceased-donor livers is not feasible, living-donor liver transplantation (LDLT) is an attractive option for patients with hepatorenal syndrome (HRS). This study's primary objective was to describe outcomes after LDLT among HRS recipients, and the secondary objective was to determine predictors of poor renal recovery after LDLT. This single-center, retrospective study included 2185 LDLT recipients divided into HRS (n = 126, 5. Read More

Therap Adv Gastroenterol 2022 18;15:17562848221098253. Epub 2022 May 18.

Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China.

Background: Liver cirrhosis is a major global health burden worldwide due to its high risk of morbidity and mortality. Role of terlipressin for the management of liver cirrhosis-related complications has been recognized during recent years. This article aims to develop evidence-based clinical practice guidance on the use of terlipressin for liver cirrhosis-related complications. Read More

J Assoc Physicians India 2022 May;70(5):11-12

Professor & Head, Department of Medicine, Mount Zion Medical College, Chayalode, Kerala.

This report describes a case of Autoimmune Hemolytic Anemia that was possibly induced by COVID-19 in a patient with history of Chronic Liver Disease and Diabetes Mellitus. Autoimmune responses like hemolytic anemia are known to be triggered by viral infections. COVID-19 is reported to be inducing Autoimmune Hemolytic Anemia in susceptible individuals. Read More

Biol Trace Elem Res 2022 May 19. Epub 2022 May 19.

Department of Pharmacology and Toxicology, Faculty of Pharmacy, Al-Azhar University, Assiut Branch, Assiut, 71524, Egypt.

Cadmium (Cd) is a serious pollutant in the environment. Candesartan is an angiotensin II (Ang II) receptor antagonist with promising diverse health benefits. The current study is planned to investigate the hepatorenal protective effects of candesartan against Cd-induced hepatic and renal intoxication. Read More

Ann Hepatol 2022 May 10;27(4):100708. Epub 2022 May 10.

Metabolic Unit, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán" ["Salvador Zubirán" National Institute of Medical Sciences and Nutrition], Mexico City, Mexico. Electronic address:

Cirrhosis is characterized by a prolonged asymptomatic period in which the inflammation persists, increasing as the disease progresses. Proinflammatory cytokines and pro-oxidant molecules are key in the development of organ dysfunction. Cirrhosis progression and worsening of portal hypertension bring about bacterial translocation and systemic dissemination via portal circulation of bacterial products, and molecular patterns associated with damage, which exacerbate the systemic Inflammation. Read More

J Clin Exp Hepatol 2022 Mar-Apr;12(2):575-594. Epub 2021 Sep 16.

Department of Gastroenterology and Hepatology, Kalinga Institute of Medical Science, Bhubaneswar, Odisha, India.

Hyponatremia is the most common electrolyte abnormality in patients with decompensated cirrhosis on Liver Transplantation (LT) waiting list. Most of these patients have dilutional or hypervolemic hyponatremia secondary to splanchnic vasodilatation. Excessive secretion of the antidiuretic hormone also plays an important role. Read More

J Clin Exp Hepatol 2022 Mar-Apr;12(2):417-427. Epub 2021 Jun 25.

Department of Hepatology, Asian Institute of Gastroenterology, Hyderabad, India.

Background: Acute kidney injury (AKI) is common in the perioperative transplant period and is associated with poor outcomes. Few studies reported a reduction in AKI incidence with terlipressin therapy by counteracting the hemodynamic alterations occurring during liver transplantation. However, the effect of terlipressin on posttransplant outcomes has not been systematically reviewed. Read More

J Clin Exp Hepatol 2022 Mar-Apr;12(2):336-342. Epub 2021 Aug 18.

Department of Hepatology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.

Background: Spontaneous bacterial peritonitis (SBP) heralds increased mortality in cirrhosis, mandating strategies for prophylaxis. Norfloxacin has been the recommended choice for SBP prevention. However, its use has raised concerns about antibiotic resistance. Read More

Ann Transl Med 2022 Apr;10(7):406

Department of Infection, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

Background: The prognosis for patients with chronic hepatitis B virus (HBV)-related subacute liver failure is poor. Thus, accurate prognostication would facilitate management and optimize liver allocation. This study aimed to explore the risk factors for HBV-related subacute liver failure and establish a risk model. Read More

Clin Drug Investig 2022 Jun 6;42(Suppl 1):15-23. Epub 2022 May 6.

Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Insituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Centro de Investigación Biomédica en Red (CIBERehd), Universidad de Alcalá, Ctra. Colmenar Viejo, km 9,100, 28034, Madrid, Spain.

Systemic complications often occur in patients with advanced liver disease. In particular, the development of renal complications (acute kidney injury, hepatorenal syndrome), acute-on-chronic liver failure, cardiopulmonary diseases, or relative adrenal insufficiency can be serious in patients with advanced liver disease and may determine the patient's quality of life and prognosis. Therefore, the early diagnosis of possible complications is the key to the prompt initiation of specific treatments that can improve quality of life and survival. Read More

Cureus 2022 Apr 1;14(4):e23720. Epub 2022 Apr 1.

Medicine, Icahn School of Medicine at Mount Sinai, New York City Health and Hospitals/Queens, New York City, USA.

Neuroendocrine tumors are tumors that arise from the enterochromaffin cells in the neuroendocrine tissue found throughout the body, particularly the digestive tract, pancreas, and thymus. Neuroendocrine tumors of the esophagus are extremely rare and highly aggressive in nature. We present the case of a 55-year-old Hispanic male who initially presented to the emergency department with right-sided abdominal pain. Read More

Clin Liver Dis 2022 05 1;26(2):255-268. Epub 2022 Apr 1.

Department of Medicine, Division of Hepatology, Sandra Atlas Bass Center for Liver Diseases and Transplantation, Manhasset, NY 11030, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, 400 Community Drive, Manhasset, NY 11030, USA. Electronic address:

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. Read More

Clin Liver Dis 2022 05 1;26(2):181-201. Epub 2022 Apr 1.

Department of Internal Medicine, Division of Hepatology, Sandra Atlas Bass Center for Liver Diseases & Transplantation, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, 400 Community Drive, Manhasset, NY 11030, USA. Electronic address:

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. Read More

Clin Liver Dis 2022 05 30;26(2):165-179. Epub 2022 Mar 30.

Division of Hepatology and Sandra Atlas Bass Center for Liver Diseases, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, 400 Community Drive, Manhasset, NY 11030, USA.

Hepatorenal syndrome (HRS) is defined as a functional renal failure without major histologic changes in individuals with severe liver disease and it is associated with a high mortality rate. Renal hypoperfusion due to marked vasoconstriction as a result of complex circulatory dysfunction has been suggested to be the cornerstone of HRS. Splanchnic and peripheral arterial vasodilation and cirrhotic cardiomyopathy result in effective arterial hypovolemia and compensatory activation of vasoconstrictor mechanisms. Read More

Clin Drug Investig 2022 Jun 27;42(Suppl 1):25-31. Epub 2022 Apr 27.

Servicio de Hepatología, Hemodinámica Hepática. Hospital Clínic, Barcelona, Spain.

Portal hypertension is a major complication of cirrhosis characterized by a pathological hepatic venous pressure gradient (HVPG) ≥ 5 mmHg. The structural changes observed in the liver leading to intrahepatic vascular resistance and, consequently, portal hypertension appear in the early stages of cirrhosis. Clinically significant portal hypertension (HVPG ≥ 10 mmHg) is associated with several clinical consequences, such as ascites, hyponatremia, gastroesophageal variceal bleeding, hepatorenal syndrome, cardiopulmonary complications, adrenal insufficiency, and hepatic encephalopathy. Read More

Arab J Gastroenterol 2022 May 23;23(2):125-133. Epub 2022 Apr 23.

Department of Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar; College of Medicine, QU Health, Qatar University, Doha, Qatar; Weill Cornell Medical College, Qatar. Electronic address:

Hepatorenal syndrome (HRS) is acute kidney injury (AKI) that occurs without evidence of structural abnormalities in the kidneys in patients with liver disease. It is thought to be due to splanchnic vasculature dilatation that is associated with intense increase of renal arteries' tone, leading to renal cortex ischemia and AKI. Nitric oxide, endotoxins, neurohormonal changes, bacterial infection, high serum bilirubin and bile acids are examples for factors contributing to HRS development. Read More