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Ter Arkh 2019 Apr 15;91(4):114-117. Epub 2019 Apr 15.

Obstetric Clinic, University Hospital "Dr. Georgi Stranski", Department of obstetrics and gynecology, Medical University.

Pregnancy in patients with liver cirrhosis and portal hypertension occurs very rare, because of their significantly derailed reproductive functions. Тhe risks for the mother and the fetus are connected with worsening of the portal hypertension, progression of decompensated liver cirrhosis and development of its complications: liver failure, ascites, hepatorenal syndrome, hepatic encephalopathy and variceal hemorrhage, and with increased incidence of spontaneous abortions and abnormal uterine bleeding. The decision for continuation of the pregnancy in cirrhotic patients must be based on individual approach and a multidisciplinary team consisting of obstetricians, hepatologists, anesthesiologists, surgeons and hematologists must participate in the therapy. Read More

Med Sci Monit 2020 Jun 30;26:e923805. Epub 2020 Jun 30.

Department of Gastroenterology, Endocrinology and Internal Diseases, Military Institute of Medicine, Warsaw, Poland.

BACKGROUND This study aimed to evaluate the Molecular Adsorbent Recirculating System (MARS) effectiveness in patients with alcohol-related acute-on-chronic liver failure (AoCLF) complicated with type 1 hepatorenal syndrome (HRS). So far, MARS efficacy and safety has been demonstrated in various acute liver failure scenarios. MATERIAL AND METHODS Data from 41 MARS procedures (10 patients with type 1 HRS, in the course of alcohol-related AoCLF were considered for this study. Read More

Ter Arkh 2019 Aug 15;91(8):148-154. Epub 2019 Aug 15.

Sechenov First Moscow State Medical University (Sechenov University).

The natural course of cirrhosis is characterized by a shift from a compensated stage without clinical manifestations to a subsequent decompensated stage, which is characterized by the development of obvious clinical symptoms, the most frequent of which are ascites, bleeding from varicose veins, bacterial infections, encephalopathy. The articles and reviews of recent years emphasize the importance of etiotropic treatment of liver cirrhosis at any stage, including the final one. In addition, pathogenetic and symptomatic therapy aimed at treating complications of cirrhosis of the liver: ascites, dilution hyponatremia, gastrointestinal bleeding, bacterial infections, and kidney damage comes to the forefront at the stage of decompensation, which allows the patient to be on the waiting list for liver transplantation. Read More

Nephrol Dial Transplant 2020 Jun 29. Epub 2020 Jun 29.

Department of Anesthesiology and Perioperative Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA.

The traditional taxonomy of acute kidney injury (AKI) has remained pervasive in clinical nephrology. While the terms 'prerenal', 'intrarenal' and 'postrenal' highlight the diverse pathophysiology underlying AKI, they also imply discrete disease pathways and de-emphasize the nature of AKI as an evolving clinical syndrome with multiple, often simultaneous and overlapping, causes. In a similar vein, prerenal AKI comprises a diverse spectrum of kidney disorders, albeit one that is often managed by using a standardized clinical algorithm. Read More

United European Gastroenterol J 2020 Jun 26:2050640620938525. Epub 2020 Jun 26.

Hepatology, University Clinic for Visceral Surgery and Medicine, Bern, Switzerland.

Background: Treatment of refractory ascites in liver cirrhosis is challenging. Transjugular intrahepatic portosystemic shunt and alfapump® have been proposed for the management, but few data comparing both exist.

Aims: The aim of this study was to evaluate the characteristics and outcomes of patients treated with transjugular intrahepatic portosystemic shunt and alfapump® for refractory ascites at our centre. Read More

Liver Transpl 2020 Jun 23. Epub 2020 Jun 23.

Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, NY, USA.

Hepatorenal syndrome is one of the most ominous complications of portal hypertension in patients with decompensated cirrhosis and ascites. It is associated with very high mortality on the waiting list. Liver transplantation is the most successful therapeutic option for patients with hepatorenal syndrome. Read More

Zhonghua Gan Zang Bing Za Zhi 2020 May;28(5):381-385

Department of Infectious Diseases, the First Hospital of Peking University, Beijing 100034, China.

Renal dysfunction is common in patients with decompensated cirrhosis. The types include of prerenal and postrenal, structural kidney disease, interstitial nephritis and functional renal failure, which is related to hemodynamic changes without obvious histopathological changes, the most common of which are acute kidney injury and hepatorenal syndrome. In recent years, there have been updated to some extents in the liver cirrhosis combined with kidney diseases, especially in the definition, classification, pathogenesis, diagnostic criteria, management process of acute kidney injury and hepatorenal syndrome. Read More

Dig Dis Sci 2020 Jun 8. Epub 2020 Jun 8.

Department of Gastroenterology and Liver Transplant Unit, Austin Health, Melbourne, VIC, Australia.

Med Clin North Am 2020 Jul;104(4):647-662

Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1109, New York, NY 10029, USA.

Hospitalists often care for patients with liver disease, including those with acute liver injury and failure and patients with complications of decompensated cirrhosis. Acute liver failure is a true emergency, requiring intensive care and oftentimes transfer of the patient to a liver transplant center. Patients with decompensated cirrhosis have complications of portal hypertension, including variceal hemorrhage, ascites, spontaneous bacterial peritonitis, and hepatic encephalopathy. Read More

Aliment Pharmacol Ther 2020 Jul 4;52(2):351-358. Epub 2020 Jun 4.

Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.

Background: Hepatorenal syndrome and acute kidney injury are common complications of decompensated cirrhosis, and terlipressin is recommended as first-line vasoconstrictor therapy. However, data on its use outside of clinical trials are lacking.

Aims: To assess practice patterns and outcomes around vasoconstrictor use for hepatorenal syndrome in UK hospitals. Read More

Dtsch Med Wochenschr 2020 Jun 3;145(11):722-726. Epub 2020 Jun 3.

Universitätsklinikum Frankfurt am Main - Medizinische Klinik I, Goethe-Universität Frankfurt am Main.

The recommended indications for short-term use of human albumin in patients with decompensated cirrhosis are the following: prevention of paracenteses induced circulatory dysfunction, treatment of hypovolemia, prevention of hepatorenal syndrome in high-risk patients with spontaneous bacterial peritonitis, as well as treatment of hepatorenal syndrome. Liver cirrhosis is associated with systemic inflammation, which is further increased in decompensated cirrhosis and acute-on-chronic liver failure. Besides its function as plasma expander, albumin is known to have pleiotropic non-oncotic properties. Read More

Medicine (Baltimore) 2020 May;99(22):e20413

Department of Nephrology, the key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital.

Background: Autosomal recessive polycystic kidney disease (ARPKD) is an autosomal recessive hepatorenal fibrocystic syndrome. The majority of ARPKD patients progress to end-stage renal disease. Precise molecular diagnosis of ARPKD has proven valuable for understanding its mechanism and selecting optimal therapy. Read More

Hepatol Int 2020 May 29. Epub 2020 May 29.

Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095, Jiefang Avenue, Wuhan, 430030, Hubei Province, China.

Background And Aims: Artificial liver support systems (ALSS) have been shown to significantly reduce mortality in patients with acute-on-chronic liver failure (ACLF). However, the characteristics of patients who would benefit most from ALSS treatment are poorly understood. This study aimed to delineate the indicators for ALSS and evaluate the effectiveness of plasma perfusion combined with plasma exchange (PP + PE) in patients with hepatitis B virus-related ACLF (HBV-ACLF). Read More

Dig Dis Sci 2020 May 29. Epub 2020 May 29.

Department of Gastroenterology and Hepatology, Sunshine Coast University Hospital, 6 Doherty St, Birtinya, QLD, Australia.

J Hepatobiliary Pancreat Sci 2020 May 28. Epub 2020 May 28.

Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital, No.10 Tieyi Road, Yangfangdian street, Haidian District, Beijing, 100038, China.

Purpose: To investigate whether portal level of High-mobility group protein B1 (HMGB1) is associated with hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS).

Methods: We enrolled 127 consecutive patients who underwent TIPS and collected portal and peripheral blood samples in our department from December 2017 to May 2019. HMGB1 levels were determined using enzyme-linked immunosorbent assay kits. Read More

J Hepatol 2020 May 21. Epub 2020 May 21.

Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBEREHD, Universidad de Alcalá, Madrid, Spain. Electronic address:

Background And Aims: The safety of non-selective -blockers (NSBB) has been questioned in refractory ascites (RA). We studied the effects of NSBB on cardiac systolic function, systemic hemodynamics, and renal perfusion pressure (RPP) and function in patients with diuretic-responsive (DRA) and RA.

Methods: Prospective pre-post repeated-measures study in cirrhotic patients, 18 with DRA and 20 with RA on NSBB for variceal bleeding prophylaxis. Read More

Transplantation 2020 May 11. Epub 2020 May 11.

The University of Melbourne, Parkville, Victoria, Australia.

Background: Hepatorenal syndrome (HRS) is a serious complication of liver cirrhosis with poor survival in the absence of liver transplantation (LT). HRS represents a state of profound circulatory and cardiac dysfunction. Whether it increases risk of perioperative major adverse cardiovascular events (MACE) following LT remains unclear. Read More

J Virus Erad 2020 Apr 30;6(2):52-60. Epub 2020 Apr 30.

Department of Molecular and Clinical Pharmacology, University of Liverpool, UK.

Background: Many treatments are being assessed for repurposing to treat coronavirus disease 2019 (COVID-19). One drug that has shown promising results is nitazoxanide. Unlike other postulated drugs, nitazoxanide shows a high ratio of maximum plasma concentration (C), after 1 day of 500 mg twice daily (BD), to the concentration required to inhibit 50% replication (EC) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (C: EC roughly equal to 14:1). Read More

Eur J Gastroenterol Hepatol 2020 May 2. Epub 2020 May 2.

Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung.

Background And Aim: Tenofovir disoproxil fumarate (TDF) and entecavir are effective antiviral medications that are recommended as first-line monotherapies for the treatment of chronic hepatitis B (CHB) infection, including decompensated liver cirrhosis with ascites. Acute kidney injury (AKI) commonly occurs in patients with cirrhosis and ascites. The aim of this study was to compare the development of AKI during TDF and entecavir treatment of CHB patients with cirrhotic refractory ascites. Read More

Ann Transl Med 2020 Mar;8(6):340

Liver Cirrhosis Group, Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), Shenyang 110840, China.

Background: Renal dysfunction is a serious morbidity in cirrhotic patients with acute upper gastrointestinal bleeding (AUGIB). Terlipressin is the first-line treatment choice for acute variceal bleeding and hepatorenal syndrome (HRS). This study aimed to assess the effect of terlipressin on renal function in patients with liver cirrhosis and AUGIB. Read More

Best Pract Res Clin Anaesthesiol 2020 Mar 17;34(1):69-78. Epub 2019 Dec 17.

Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Canada; Department of Critical Care Medicine, University of Alberta, Edmonton, Canada. Electronic address:

Acute kidney injury (AKI) is associated with high perioperative mortality in patients undergoing liver transplantation (LT). In the era of Model of End-stage Liver Disease score-based allocation, more patients with impaired renal function are receiving LT. The majority of preoperative AKI is secondary to azotemia, including hepatorenal syndrome - a progressive form of renal impairment unique to liver failure. Read More

Dig Dis Sci 2020 Apr 13. Epub 2020 Apr 13.

Unit of Addiction and Hepatology, Alcohological Regional Centre, ASL3 c/o Ospedale Policlinico San Martino, Genoa, Italy.

Gastroenterol Rep (Oxf) 2020 Apr 13;8(2):111-118. Epub 2019 Sep 13.

Department of Nephrology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, P. R. China.

Background: Observational studies suggest that hepatorenal syndrome (HRS) patients who receive pharmacological therapy before orthotopic liver transplantation display a post-transplant outcome similar to those without HRS. The aim of this study was to comprehensively compare and rank the pharmacological therapies for HRS.

Methods: We reviewed PubMed, Elsevier, Medline, and the Cochrane Central Register of Controlled Trials (CENTRAL) for studies that were published between 1 January 1999 and 24 February 2018. Read More

Front Med (Lausanne) 2020 24;7:96. Epub 2020 Mar 24.

Medical Microbiology and Immunology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

The relationship between liver cirrhosis and () is a debatable matter. The aim of this study is to evaluate the possible association between infection and liver cirrhosis. A single-center prospective cohort pilot study of 558 patients with cirrhosis was followed up for 1 year. Read More

Rev Cardiovasc Med 2020 Mar;21(1):119-122

Department of Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, P. R. China.

Arteriovenous fistula (AVF) is a rare complication of the abdominal aortic aneurysm (AAA) with complex clinical features. However, AVF and AAA usually cause no symptoms except when they rupture. This case study demonstrated that ultrasonography was a rapid and non-invasive method for the initial assessment of AAA and AVF. Read More

Eur J Gastroenterol Hepatol 2020 Mar 20. Epub 2020 Mar 20.

Department of Pharmacy, University of Florida Health Shands, Gainesville.

Background: Hepatorenal syndrome (HRS) remains a serious complication of cirrhosis with a high mortality rate. There is little information on the effect of standardizing albumin, midodrine and octreotide combination on treatment response in patients with HRS.

Objective: The aim of the study was to determine the impact of a standardized HRS treatment regimen on renal function recovery. Read More

Scand J Gastroenterol 2020 Apr 1;55(4):383-394. Epub 2020 Apr 1.

Gastro Unit, Medical Division, Hvidovre Hospital, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.

Detailed knowledge and understanding of the pathophysiological mechanisms and changes in hepatic and splanchnic function leading to the development of haemodynamic changes and portal hypertension in patients with cirrhosis are essential since it guides the search for targets to ameliorate liver-related abnormalities. Recent research has focused on the gut-liver axis, changes in intestinal permeability, translocation of bacterial products, and inflammation as important drivers of haemodynamic alterations and thereby targets for treatment. Additionally, treatment strategies should focus on microbiotic modulation, antiangiogenics, anti-inflammatory strategies, and modulation of bile acid metabolism. Read More

United European Gastroenterol J 2020 Jun 26;8(5):528-535. Epub 2020 Feb 26.

Department of Medical and Surgical Sciences, S Orsola-Malpighi University Hospital, Bologna, Italy.

Albumin is currently employed as a plasma expander to prevent and treat specific complications of cirrhosis with ascites, such as the prevention of paracentesis-induced circulatory dysfunction and renal dysfunction induced by spontaneous bacterial peritonitis, as well as the diagnosis and treatment of acute kidney injury and hepatorenal syndrome. Recently, evidence has shown that long-term albumin administration in patients with decompensated cirrhosis reduces mortality and incidence of complications, eases the management of ascites, is cost effective, and has a good safety profile. Read More

Int J Clin Exp Pathol 2020 1;13(2):192-202. Epub 2020 Feb 1.

Department of Gastroenterology and Hepatology, The First Hospital of Shanxi Medical University Taiyuan 030001, China.

Background: Hepatorenal and hepatopulmonary syndrome are common clinical diseases; however, their mechanisms have not been fully elucidated. Our aim was to determine whether liver injury by bile duct ligation (BDL) causes modifications in kidney and lung tissue in mice, and to explore the possible mechanism of these changes.

Methods: BDL in mice was used as a research model. Read More

Z Gastroenterol 2020 Mar 20;58(3):254-266. Epub 2020 Mar 20.

Klinik für Nieren- und Hochdruckerkrankungen, Diabetologie und Endokrinologie, Medizinische Fakultät der Otto-von-Guericke-Universität, Magdeburg, Deutschland.

The hepatorenal syndrome (HRS) is only a part of the wide spectrum of renal injury in patients with end-stage liver cirrhosis. Besides that, the advanced liver disease itself, or its underlying causes, as well as comorbidities, like diabetes mellitus, adiposity and arterial hypertension, can directly cause parenchymal renal insults (bile acid nephropathy, ischemic tubular injury, diabetic/hypertensive nephropathy, hepatitis B- and C-associated glomerulonephritis etc.). Read More

JHEP Rep 2020 Apr 28;2(2):100069. Epub 2020 Jan 28.

School of Public Health, University of Haifa, Haifa, Israel.

Background & Aims: The inverse association between non-alcoholic fatty liver disease (NAFLD) and diets rich in fruit and vegetables has been demonstrated, but the specific compounds that may be responsible for this association need to be elucidated. The aim of this study was to test the association between phenolic acid consumption, NAFLD, and insulin resistance (IR).

Methods: A cross-sectional cohort of individuals included in a metabolic screening program was studied. Read More

Indian J Gastroenterol 2020 Feb 17;39(1):50-59. Epub 2020 Mar 17.

Institute of Preclinical and Clinical Pharmacology with Toxicology, Faculty of Medicine Skopje, University "SS. Cyril and Methodius", - Skopje, Macedonia, Skopje, Macedonia.

Background/purpose: Non-alcoholic fatty liver disease (NAFLD) patients are at increased risk of liver-related as well as cardiovascular mortality, including diabetes, coronary heart disease, and stroke, independently of traditional cardiovascular risk factors and metabolic syndrome. The aim of this study was to find out the predictive impact of hepatorenal index (HRI) in the detection of impaired glucose metabolism in asymptomatic NAFLD patients.

Methods: B-mode ultrasound examinations were performed and ultrasound images from all 89 NAFLD patients aged 50. Read More

Int J Biol Sci 2020 10;16(7):1166-1179. Epub 2020 Feb 10.

Department of Physiology and Pathophysiology, State Key Laboratory of Medical Neurobiology, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China.

Carbon tetrachloride (CCl4), Concanavalin A (ConA), bile duct ligation (BDL), and liver resection (LR) are four types of commonly used mouse models of acute liver injury. However, these four models belong to different types of liver cell damage while their application situations are often confounded. In addition, the systematic changes of multiple extra-liver organs after acute liver injury and the crosstalk between liver and extra-liver organs remain unclear. Read More

Skinmed 2020 1;18(1):46-49. Epub 2020 Jan 1.

Department of Dermatology, Hofstra Northwell School of Medicine, Manhasset, NY;

A 45-year-old woman with cirrhosis secondary to alcohol abuse was transferred from an outside hospital for management of a painful cutaneous eruption, progressively worsening over 2 weeks. On examination, the patient was a middle-aged white woman lying in bed in no acute distress, with jaundice and a protuberant abdomen consistent with ascites. The patient was afebrile (98. Read More

Hepatology 2020 Mar 10. Epub 2020 Mar 10.

Department of Medicine, Division of Gastroenterology and Hepatology, University of North Carolina (UNC) Health Care, Chapel Hill, NC, United States.

Background & Aims: Anesthesia services for endoscopic procedures have proliferated with the promise of increased comfort and safety. Cirrhosis patients are higher risk for sedation, yet limited data are available describing anesthesia complications in this population.

Approach & Results: This cross-sectional study utilized the National Anesthesia Clinical Outcomes Registry, a multi-center quality improvement database from 2010 to 2015. Read More

J Viral Hepat 2020 Mar 5. Epub 2020 Mar 5.

Hangzhou Sixth People's Hospital/Xixi Hospital of Hangzhou, Zhejiang Chinese Medical University, Hangzhou, China.

Acute kidney injury (AKI) in patients with acute-on-chronic liver failure (ACLF) is a distinct syndrome to that in patients with cirrhosis, yet is less characterized. The aim of this meta-analysis was to investigate the impact of AKI on outcome of ACLF. We searched PubMed, Web of Science and Cochrane Library for original articles that evaluated the impact of AKI on outcome of ACLF from 2011 to 2019. Read More

Dig Dis Sci 2020 Mar 2. Epub 2020 Mar 2.

Division of Gastroenterology and Hepatology, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94304, USA.

Background: Data on the current estimates of the disease burden of Clostridioides difficile (C. difficile) infection in the setting of end-stage liver disease (ESLD) are emerging.

Aims: We examined the recent trends and predictors of hospitalizations and in-hospital mortality from C. Read More

Int J Mol Sci 2020 Feb 29;21(5). Epub 2020 Feb 29.

Department of Endocrinology, "La Paz" University Hospital. Paseo de la Castellana, 261, 28046 Madrid, Spain.

Somatostatin analogs are an invaluable therapeutic option in the diagnosis and treatment of somatotropinomas, thyrotropinomas, and functioning and non-functioning gastroenteropancreatic neuroendocrine tumors. They should also be considered an effective and safe therapeutic alternative to corticotropinomas, gonadotropinomas, and prolactinomas resistant to dopamine agonists. Somatostatin analogs have also shown to be useful in the treatment of other endocrine diseases (congenital hyperinsulinism, Graves' orbitopathy, diabetic retinopathy, diabetic macular edema), non-endocrine tumors (breast, colon, prostate, lung, and hepatocellular), and digestive diseases (chronic refractory diarrhea, hepatorenal polycystosis, gastrointestinal hemorrhage, dumping syndrome, and intestinal fistula). Read More

Euroasian J Hepatogastroenterol 2019 Jul-Dec;9(2):71-77

Department of Community Medicine, Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India.

Background: The rate of readmission to the hospital and mortality within 3 months is used as a quality measure for hospitalized patients with advanced liver disease; however, the topic has not been studied adequately under Indian context.

Materials And Methods: This study was a longitudinal study conducted from March 2017 to March 2018. Patients admitted with liver cirrhosis at inpatient hepatology service in Tertiary Health Care Centre, Mysore, India, were included for the study. Read More

Cureus 2020 Jan 20;12(1):e6706. Epub 2020 Jan 20.

Radiology, Indira Gandhi Medical College & Research Institute, Pondicherry, IND.

Scrub typhus is a multisystem disease, and the respiratory system is commonly involved. Scrub typhus-related parkinsonism has been reported in three patients previously, and none of them underwent a lumbar puncture. Cerebral salt wasting is generally observed in vascular emergencies of the brain. Read More

Ci Ji Yi Xue Za Zhi 2020 Jan-Mar;32(1):47-52. Epub 2019 Feb 18.

Division of Gastroenterology, Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.

Objective: Ascites, hepatic encephalopathy, hepatorenal syndrome, spontaneous bacterial peritonitis, and esophageal variceal bleeding are major complications associated with cirrhosis. The presence of these complications indicates poor hepatic reserve. This study aimed to identify the effects of poor hepatic reserve on mortality in cirrhotic patients with bacterial infections. Read More

Clin Nephrol 2020 Apr;93(4):187-194

Background: Incident acute kidney injury (AKI) in critically ill patients with acute on chronic liver failure (ACLF) is associated with poor prognosis. The role of continuous renal replacement therapy (CRRT) is not well established for patients with ACLF and AKI.

Materials And Methods: We conducted a retrospective cohort study to examine clinical outcomes in 66 patients with ACLF and AKI requiring CRRT. Read More

J Clin Gastroenterol 2020 Apr;54(4):314-321

Department of Medicine, Division of Nephrology, David Geffen School of Medicine at UCLA, Los Angeles, CA.

Renal dysfunction in cirrhosis is common and is associated with increased mortality. Identifying and treating reversible causes of renal disease can significantly improve outcomes. The etiology, approach, and evaluation of renal disease in this group of patients is similar to the noncirrhosis patient, with a few specific caveats. Read More

Front Pharmacol 2020 31;11. Epub 2020 Jan 31.

Medical Microbiology and Immunology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

Background And Purpose: Predictors of response to type-1 hepatorenal syndrome (HRS) therapy are urgently needed. This study's purpose is to evaluate the proposed predictors in these patients.

Methods: Forty-two type-1 HRS patients with cirrhosis were treated with albumin and terlipressin. Read More

Dig Dis Sci 2020 Feb 15. Epub 2020 Feb 15.

Division of Gastroenterology and Hepatology, Newark University Hospital/Rutgers - New Jersey Medical School, Newark, NJ, USA.

Background: It has been reported that transjugular intrahepatic portosystemic shunting (TIPS) might be utilized as a salvage option for hepatorenal syndrome (HRS), while randomized controlled trials are pending and real-world contemporary data on inpatient mortality is lacking.

Methods: We conducted an observational retrospective cohort study from the National Inpatient Sample from 2005 to 2014. We included all adult patients admitted with HRS and cirrhosis, using ICD 9-CM codes. Read More

Ann Surg Treat Res 2020 Feb 31;98(2):102-109. Epub 2020 Jan 31.

Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Purpose: Hepatorenal syndrome (HRS) is a fatal complication in patients with end-stage liver disease awaiting liver transplantation (LT). HRS often develops in patients with high model for end-stage liver disease (MELD) score. This study investigated the outcomes of peritransplant management of HRS in a high-volume LT center in Korea for 2 years. Read More

Eur J Gastroenterol Hepatol 2020 Apr;32(4):535-539

Department of Medicine, GMC Patiala, Punjab, India.

Introduction: The present study was conducted to compare the efficacy and side effects of Spironolactone and Eplerenone in management of ascites due to liver cirrhosis.

Materials And Methods: 105 patients of ascites with liver cirrhosis were randomized into three groups of 35 patients each. Group I was given Spironolactone 100 mg, group II was given Eplerenone 100 mg and group III was given Eplerenone 50 mg. Read More

JHEP Rep 2020 Feb 20;2(1):100063. Epub 2019 Dec 20.

Swiss Liver Center, UVCM, Inselspital, Bern University Hospital, Department of Biomedical Research, University of Bern, Bern, Switzerland.

Non-selective beta-blockers (NSBBs) are the mainstay of treatment for portal hypertension in the setting of liver cirrhosis. Randomised controlled trials demonstrated their efficacy in preventing initial variceal bleeding and subsequent rebleeding. Recent evidence indicates that NSBBs could prevent liver decompensation in patients with compensated cirrhosis. Read More

JHEP Rep 2019 Aug 17;1(2):107-113. Epub 2019 May 17.

Liver Transplant Unit, Austin Health, Heidelberg, Victoria, Australia.

Background & Aims: Portal hypertension contributes to the pathogenesis of malnutrition and sarcopenia in cirrhosis via multiple mechanisms. Terlipressin is a vasopressin analogue that we administer via continuous outpatient infusion, as a bridge to transplantation in patients with hepatorenal syndrome or refractory ascites. We describe, for the first time, the impact of outpatient terlipressin on nutritional and muscle parameters. Read More

JHEP Rep 2019 May 18;1(1):44-52. Epub 2019 Mar 18.

Division of Gastroenterology, University of Alberta, Edmonton, Canada.

Cirrhosis is a leading cause of morbidity and mortality throughout the world. Significant complications include variceal bleeding, hepatic encephalopathy, hepatorenal syndrome, and infection. When these complications are severe, admission to the intensive care unit (ICU) is often required for organ support and management. Read More