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Sci Rep 2019 Apr 18;9(1):6251. Epub 2019 Apr 18.

Department of Health Statistics, School of Public Health, Shanxi Medical University, No.56 XinJian South Road, Taiyuan, Shanxi, 030001, China.

This study aimed to explore the related factors and strengths of hepatic cirrhosis complicated with hepatic encephalopathy (HE) by multivariate logistic regression analysis and tabu search-based Bayesian networks (BNs), and to deduce the probability of HE in patients with cirrhosis under different conditions through BN reasoning. Multivariate logistic regression analysis indicated that electrolyte disorders, infections, poor spirits, hepatorenal syndrome, hepatic diabetes, prothrombin time, and total bilirubin are associated with HE. Inferences by BNs found that infection, electrolyte disorder and hepatorenal syndrome are closely related to HE. Read More

Clin J Am Soc Nephrol 2019 Apr 17. Epub 2019 Apr 17.

Division of Nephrology and Hypertension, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California

Hepatorenal syndrome is a severe complication of end-stage cirrhosis characterized by increased splanchnic blood flow, hyperdynamic state, a state of decreased central volume, activation of vasoconstrictor systems, and extreme kidney vasoconstriction leading to decreased GFR. The contribution of systemic inflammation, a key feature of cirrhosis, in the development of hepatorenal syndrome has been highlighted in recent years. The mechanisms by which systemic inflammation precipitates kidney circulatory changes during hepatorenal syndrome need to be clarified. Read More

Clin Liver Dis (Hoboken) 2013 Jun 21;2(3):136-139. Epub 2013 Jun 21.

From the Liver Unit, Hospital Clínic, University of Barcelona School of Medicine; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd); and Instituto Reina Sofía de Investigación Nefrológica (IRSIN), Barcelona, Spain.

Clin J Gastroenterol 2019 Apr 12. Epub 2019 Apr 12.

Department of Medicine, Drexel University College of Medicine, Philadelphia, PA, 19102, USA.

Liver cirrhosis is associated with multiple vascular syndromes affecting almost all body systems. Many of these syndromes are directly related to impaired liver function and sometimes reversible after liver transplantation while others arise secondary to portal hypertension and ascites. Altered expression of angiogenic and vasoactive compounds (most importantly nitric oxide), endothelial dysfunction, dysregulated neurohormonal control, and systemic inflammatory state play differential roles in mediating homeostatic instability and abnormal vasogenic response. Read More

Curr Treat Options Gastroenterol 2019 Apr 9. Epub 2019 Apr 9.

Division of Nephrology (Kidney-Liver Program), Department of Medicine, University of Washington, 356521, 1959 NE Pacific Street, Seattle, WA, 98195-6521, USA.

Purpose Of Review: Albumin has repeatedly been shown to be beneficial in treating patients with decompensated cirrhosis. We reviewed the medical literature regarding indications for the use of intravenous albumin in cirrhosis, with particular focus on the ways in which albumin can help mitigate hepatorenal physiology.

Recent Findings: Albumin has long been used as the preferred agent for volume expansion in patients with decompensated cirrhosis. Read More

Mayo Clin Proc 2019 Apr;94(4):714-726

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.

Portal hypertension is a major complication of cirrhosis, and its consequences, including ascites, esophageal varices, hepatic encephalopathy, and hepatorenal syndrome, lead to substantial morbidity and mortality. The past several decades have seen major improvements in the clinical management of complications of portal hypertension, resulting in substantial gains in patient outcomes. However, important challenges remain. Read More

Mediators Inflamm 2019 25;2019:7537649. Epub 2019 Feb 25.

Department of Gastroenterology, Hepatology and Infectious Diseases, University Magdeburg, Leipzigerstrasse 44, 39120 Magdeburg, Germany.

Liver cirrhosis yearly causes 1.2 million deaths worldwide, ranking as the 10th leading cause of death in the most developed countries. High susceptibility to infections along with a significant risk for infection-related mortality justifies the description of liver cirrhosis as the world's most common immunodeficiency syndrome. Read More

Nephrol Dial Transplant 2019 Mar 18. Epub 2019 Mar 18.

Scientific Affairs, Mallinckrodt Pharmaceuticals, Bedminster, NJ, USA.

Background: Hepatorenal syndrome type 1 (HRS-1), a form of acute kidney injury (AKI) in cirrhosis, has a median survival of days to weeks if untreated. The impact of reduction in AKI stage on overall survival in cirrhosis, independent of HRS reversal, is unclear.

Methods: The Randomized, placEbo-controlled, double-blind study to confirm the reVERSal of HRS-1 with terlipressin study assessed terlipressin versus placebo, both with albumin, as treatment for HRS-1 for ≤14 days. Read More

Transplant Direct 2019 Mar 20;5(3):e429. Epub 2019 Feb 20.

The Liver Transplant Program, Vancouver General Hospital, Vancouver, BC, Canada.

Background: Acute kidney injury (AKI) in the setting of liver transplantation is a common and multifaceted complication. Studies in the general population have demonstrated worse prognosis with AKI episodes that persist for a longer duration. Our primary objective was to evaluate the impact of early AKI episodes that are persistent or progressive in nature, on patient outcomes and graft survival. Read More

Virol J 2019 03 14;16(1):34. Epub 2019 Mar 14.

Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China.

Background: Whether sofosbuvir is suitable for hepatitis C virus (HCV) infected patients with severe renal impairment is inconclusive. This systematic review aims to evaluate the safety and effectiveness of SOF-based regimen in the setting of stage 4 and 5 chronic kidney disease (CKD).

Methods: We conducted a systematic literature search in PubMed, Web of Science, EMBASE and Google Scholar with searching strategy: (sofosbuvir OR Sovaldi OR Harvoni OR Epclusa OR Vosevi) AND (severe kidney impairment OR severe renal impairment OR end-stage renal disease OR dialysis OR renal failure OR ESRD OR renal insufficiency OR hepatorenal syndrome OR HRS). Read More

Dig Dis Sci 2019 Mar 13. Epub 2019 Mar 13.

Division of Gastroenterology and Hepatology, Alameda Health System - Highland Hospital, 1411 East 31st Street, Highland Hospital - Highland Care Pavilion 5th Floor, Endoscopy Unit, Oakland, CA, 94602, USA.

Background: Hepatic encephalopathy (HE) is associated with substantial morbidity and mortality, contributing significant burden on healthcare systems.

Aim: We aim to evaluate trends in clinical and economic burden of HE among hospitalized adults in the USA.

Methods: Using the 2010-2014 National Inpatient Sample, we identified adults hospitalized with HE using ICD-9-CM codes. Read More

Hepatology 2019 Feb 27. Epub 2019 Feb 27.

Liver Unit, Hospital Clínic, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Catalonia, Spain.

Background/aims: Kidney biomarkers appear to be useful in differential diagnosis between Acute Tubular Necrosis (ATN) and other types of AKI in cirrhosis, particularly hepatorenal syndrome (HRS-AKI). Distinction is important because treatment is different. However, kidney biomarkers are still not used in clinical practice. Read More

Crit Rev Biomed Eng 2018 ;46(5):413-427

Center for Interdisciplinary Research, D.Y. Patil University, Kolhapur 416006, India; Department of Molecular and Cellular Medicine, Institute of Liver and Biliary Science, D-1, Vasant Kunj, New Delhi, Delhi 110070, India.

Patients with advanced liver disease have very high mortality due to associated complications such as hepatic encephalopathy, hepatorenal syndrome, and multiorgan failure. Liver transplant is the only therapeutic option for such patients; however, problems linked to availability, cost, complications, and side effects limit its practical application. The strong potential for hepatic regeneration and recovery has been documented in liver disease, without advance decomposition of the liver. Read More

Pak J Biol Sci 2019 Jan;22(1):21-27

Background And Objective: Hepatorenal syndrome (HRS) is a major public health problem in which both liver and kidney dysfunctions are encountered. The present research aimed to investigate the beneficial use of micro-encapsulated probiotic alone (Bifidobacterium bifidum, Lactobacillus delbrueckii and Streptococcus thermophilus mixture) or with green tea alcohol extract in HRS model in rats.

Materials And Methods: Flavonoids content and in vitro antioxidant activity of the extract were assessed. Read More

Iran J Public Health 2018 Dec;47(12):1883-1890

Tianjin Medical University General Hospital, Tianjin 300052, China.

Background: We aimed to explore risk factors for patients with liver cirrhosis complicated with spontaneous bacterial peritonitis (SBP).

Methods: The clinical data of 195 patients with liver cirrhosis complicated with SBP (study group), admitted from March 2014 to March 2018 in Tianjin Medical University General Hospital, Tianjin, China and 195 patients without liver cirrhosis complicated with SBP (control group) were retrospectively analyzed. Clinical manifestations of patients and laboratory findings were analyzed. Read More

Rev Med Suisse 2019 Feb;15(639):432-435

Service de néphrologie, HUG, 1211 Genève 14.

Hepatorenal syndrome is a serious and frequent complication in patients suffering from liver cirrhosis. Its most severe type is characterized by the rapid occurrence of a functional acute kidney injury. However it is mainly an exclusion diagnosis. Read More

J Med Econ 2019 May 4;22(5):421-429. Epub 2019 Mar 4.

a Mallinckrodt Pharmaceuticals, Inc , Bedminster , NJ , USA.

Objectives: Hepatorenal Syndrome (HRS) is characterized by renal failure in patients with advanced chronic liver disease (CLD) and is the leading cause of hospitalizations in CLD. This study examines the clinical and economic burden, outcomes, and unmet need of HRS treatment in US hospitals.

Method: A retrospective cohort study was conducted based on a large electronic health records database (Cerner HealthFacts) with records for hospitalized HRS patients from January 2009-June 2015. Read More

Aliment Pharmacol Ther 2019 Mar 3;49(6):789-796. Epub 2019 Feb 3.

Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.

Background: In young men, high body mass index (BMI) has been linked to liver disease later in life, but it is unclear if this also applies to women.

Aim: To study the association between BMI early in life and development of liver disease later in life in women.

Methods: We obtained data on early pregnancy BMI from 1 139 458 Swedish women between 1992 and 2015. Read More

Dig Dis Sci 2019 Jan 25. Epub 2019 Jan 25.

Unit of Internal Medicine and Hepatology (UIMH), Department of Medicine - DIMED, University of Padova, Via Giustiniani, 2, 35128, Padua, Italy.

Cirrhosis is a serious and life-threatening condition which imposes a significant socioeconomic burden on affected individuals and healthcare systems. Cirrhosis can result in portal hypertension, which may lead to major complications, including acute variceal bleeding and hepatorenal syndrome. Without prompt treatment, these complications may be life-threatening. Read More

Am J Gastroenterol 2019 Mar;114(3):464-471

Department of Family & Preventive Medicine, University of Arkansas School of Medical Sciences, Little Rock, Arkansas, USA.

Introduction: There is a lack of data on the impact of readmission to the same vs a different hospital following an index hospital discharge in cirrhosis patients.

Methods: We sought to describe rates and predictors of different-hospital readmissions (DHRs) among patients with cirrhosis and also determine the impact on cirrhosis outcomes including all-cause inpatient mortality and hospital costs. Using the national readmissions database, we identified cirrhosis hospitalizations in 2013. Read More

Curr Opin Crit Care 2019 Apr;25(2):171-178

Department of Critical Care Medicine.

Purpose Of Review: Acute kidney injury (AKI) in cirrhosis consists of varying phenotypes, with hepatorenal syndrome (HRS) representing a single entity. Prompt recognition and diagnosis of AKI cause identifies appropriate therapeutic measures. This review provides an overview of AKI definitions, highlights challenges in quantifying renal impairment in cirrhosis, lists novel diagnostic AKI biomarkers, and summarizes transplantation implications. Read More

Lancet Oncol 2019 Feb 18;20(2):282-296. Epub 2019 Jan 18.

Kindai University, Osaka-Sayama, Japan.

Background: Patients with advanced hepatocellular carcinoma and increased α-fetoprotein concentrations have poor prognosis. We aimed to establish the efficacy of ramucirumab in patients with advanced hepatocellular carcinoma and α-fetoprotein concentrations of 400 ng/mL or higher.

Methods: REACH-2 was a randomised, double-blind, placebo-controlled, phase 3 trial done at 92 hospitals, clinics, and medical centres in 20 countries. Read More

J Pineal Res 2019 May 14;66(4):e12561. Epub 2019 Feb 14.

College of Animal Science and Technology, Northwest A&F University, Yangling, Shaanxi, China.

Adipocyte-derived exosomes (Exos) serve as bioinformation-containing messengers in cell-to-cell communications, and numerous reports demonstrate that resistin, an adipokine, is strongly associated with hepatic steatosis and other fatty liver diseases, suggesting that adipose dysfunction-generated altered pattern of exosomal cytokines may contribute to shaping the physiological activities in liver. Admittedly, melatonin-mediated positive effects on various tissues/organs have been respectively reported, but regulatory mechanisms of melatonin on the crosstalk between adipose tissue and liver have been investigated rarely. Overall, we hypothesize that the crosstalk originating from adipose tissue may be another worthy regulatory pathway for melatonin ameliorating of hepatic steatosis. Read More

Dig Dis Sci 2019 Jan 19. Epub 2019 Jan 19.

Division of Endocrinology and Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA.

Background: The accuracy of diagnosis and clinical implications of the hepatoadrenal syndrome, as currently diagnosed using total cortisol, remain to be validated.

Aim: The aim of this study was to assess adrenal function using free cortisol in stable cirrhosis and study the potential implications of any abnormalities for renal and/or cardiac function.

Methods: Sixty-one stable consecutively enrolled patients with cirrhosis underwent assessment of adrenal function using the low-dose short Synacthen test, renal function by Cr-EDTA glomerular filtration rate (GFR), and cardiac function by two-dimensional echocardiography. Read More

Hepatol Int 2019 Jan 18;13(1):1-21. Epub 2019 Jan 18.

Department of Pathogen Biology, Peking University Health Science Center, Beijing, China.

The Chinese Society of Hepatology developed the current guidelines for the Management of Ascites and Its Related Complications in Cirrhosis based on the published evidences and the panelists' consensus. The guidelines provided recommendations for the diagnosis and management of cirrhotic ascites emphasizing a step-wise approach with the first-, second-, and third-line therapy. For refractory ascites, vasoconstrictors and albumin are recommended for splanchnic vasodilation and selective vasopressin (V2) receptor antagonists for moderate-to-severe hyponatremia. Read More

J Surg Case Rep 2019 Jan 9;2019(1):rjy356. Epub 2019 Jan 9.

Department of Human Pathology, Matsunami General Hospital, 185-1, Dendai, Kasamatsu, Hashima-gun, Gifu, Japan.

Madelung's disease (MD) is a rare lipid metabolic disorder of adipose tissue overgrowth, which has been reported to be related to alcohol abuse. Although it does not affect survival itself, alcoholism and metabolic disorders associated with MD can be life-threatening. Although surgical procedures and classifications have been reported, long-term follow-up has rarely been reported. Read More

Zhong Nan Da Xue Xue Bao Yi Xue Ban 2018 Dec;43(12):1337-1344

DDepartment of Infectious Diseases, Xiangya Hospital, Central South University; Hunan Province Key Laboratory of Viral Hepatitis, Changsha 410008, China.

Objective: To explore the prognostic factors for patients with drug-induced liver failure (DILF) and construct a logistic regression model (LRM).
 Methods: A retrospective analysis of clinical data was performed in 183 hospitalized patients, who were diagnosed with DILF in Xiangya Hospital, the Second Xiangya Hospital and the Third Xiangya Hospital, Central South University from January 2009 to January 2018. The patients were divided into an improved group (n=67) and an ineffective group (n=116) according to their prognosis. Read More

Hepatology 2019 May 14;69(5):2107-2119. Epub 2019 Mar 14.

Department of Gastroenterology, Hepatology, and Endocrinology, Hannover Medical School, Hannover, Germany.

Impairment of renal function often occurs in patients with liver disease. Hepatorenal syndrome is a significant cause of acute kidney injury (AKI) in patients with cirrhosis (HRS-AKI, type 1). Causes of non-HRS-AKI include cholemic nephropathy (CN), a disease that is characterized by intratubular bile casts and tubular injury. Read More

Scand J Gastroenterol 2018 Dec 8;53(12):1590-1596. Epub 2019 Jan 8.

a Department of Critical Care Medicine , Beijing Ditan Hospital, Capital Medical University , Beijing , PR China.

Introduction: Acute kidney injury (AKI) is a common and devastating complication in patients with cirrhosis. In 2015, the International Club of Ascites (ICA) proposed the definition of hepatorenal syndrome (HRS) type of AKI (HRS-AKI) in patients with cirrhosis. This study aims to evaluate the criteria of HRS-AKI in patients with cirrhosis admitted to ICU with regard to the prognosis. Read More

Semin Nephrol 2019 01;39(1):17-30

University College London Centre for Nephrology, Division of Medicine, University College London Medical School, Royal Free Hospital, London, UK. Electronic address:

Acute kidney injury (AKI) is a common presentation in patients with advanced cirrhosis hospitalized with acute decompensation. A new revised classification now divides AKI in cirrhotic patients into two broad subgroups: hepatorenal syndrome AKI (HRS AKI) and non-hepatorenal syndrome AKI (non-HRS AKI). HRS AKI represents the end-stage complication of decompensated cirrhosis with severe portal hypertension and is characterized by worsening of renal function in the absence of prerenal azotemia, nephrotoxicity, and intrinsic renal disease. Read More

Eur J Gastroenterol Hepatol 2019 Jan 4. Epub 2019 Jan 4.

Experimental and Clinical Internal Medicine, Medical Research Institute, University of Alexandria, Alexandria, Egypt.

Objectives: This study aimed to assess urinary neutrophil gelatinase-associated lipocalin (uNGAL) and serum cystatin C (sCys C) in liver cirrhosis patients with renal dysfunction and to evaluate their role in the diagnosis of the hepatorenal syndrome (HRS).

Patients And Methods: Forty-five liver cirrhosis patients were enrolled in the study and they were divided into three groups; the first group included 15 patients with normal renal function, the second group included 15 patients with HRS; and the third group included 15 patients with chronic kidney disease (CKD). There was a fourth group, which included 15 healthy controls. Read More

Am J Case Rep 2019 Jan 2;20:5-9. Epub 2019 Jan 2.

School of Pharmacy, Master Program in Clinical Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan.

BACKGROUND Hepatorenal syndrome (HRS), which is a type of functional renal impairment, is one of the most serious complications in patients with liver cirrhosis. Terlipressin can induce splanchnic vasoconstriction, which increases the renal blood flow and has beneficial effects on HRS. However, terlipressin administration may cause serious ischemic complications such as skin ischemia, peripheral gangrene, and ischemic bowel necrosis. Read More

Pediatr Transplant 2019 03 30;23(2):e13339. Epub 2018 Dec 30.

Paediatric Liver, Gastroenterology and Nutrition Centre, King's College Hospital, London, UK.

Objectives: Acute-on-chronic liver failure (ACLF) is an acute decompensation of cirrhosis complicated by other organ failure and is associated with increased mortality and morbidity. ACLF has not been studied in children with biliary atresia (BA), which is the commonest indication for pediatric liver transplantation (LT) worldwide. This study aims to evaluate ACLF and outcomes in children with BA while awaiting deceased donor LT. Read More

Liver Int 2018 Dec 29. Epub 2018 Dec 29.

Liver Unit, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain.

Background: Several lines of evidence indicate that decompensated cirrhosis is characterized by the presence of systemic inflammation. Hepatorenal syndrome (HRS-AKI) is a unique type of renal failure that occurs at late stages of cirrhosis. However, confirmation of the presence and significance of such inflammatory response in HRS-AKI is lacking. Read More

Ann Hepatol 2018 Dec;18(1):155-164

Institute of Hepatology, the Third People's Hospital of Changzhou, Changzhou, Jiangsu, China.

Introduction And Aim: Acute-on-chronic liver failure (ACLF) is a syndrome with high short-term mortality, and predicting the prognosis is challenging. This study aimed to compare the performance of neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C (CysC) in predicting the 90-day mortality in patients with hepatitis B virus (HBV)-associated ACLF (HBV-ACLF).

Materials And Methods: This prospective, observational study enrolled 54 patients with HBV-ACLF. Read More

J Am Coll Surg 2019 Apr 23;228(4):536-544.e3. Epub 2018 Dec 23.

Department of Surgery, Division of Abdominal Transplantation, University of Alabama at Birmingham, Birmingham, AL.

Background: Simultaneous liver-kidney transplantation is lifesaving, however, the utility of allocating 2 organs to a single recipient remains controversial, particularly in the face of potentially inferior survival. This study aims to determine the effect of renal indication for transplantation on simultaneous liver-kidney transplantation outcomes.

Methods: All adult recipients of combined whole liver-kidney transplants in the United Network for Organ Sharing database from 2003 to 2016 with a renal diagnosis of hypertension (HTN), diabetes mellitus (DM), acute tubular necrosis (ATN), or hepatorenal syndrome (HRS) were examined. Read More

J Korean Med Sci 2018 Dec 7;33(52):e335. Epub 2018 Dec 7.

Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.

Background: Spontaneous bacterial peritonitis (SBP) is a serious infectious complication in patients with liver cirrhosis. However, information about prognosis of SBP in hepatocellular carcinoma (HCC) patients is limited. We investigated the clinical course of SBP in HCC patients. Read More

Eur J Gastroenterol Hepatol 2019 05;31(5):626-632

Hepatology and Liver Transplant Unit, Department of Medical Area (DAME).

Objectives: Transjugular intrahepatic portosystemic shunt (TIPS) is adopted to treat refractory complications of portal hypertension, such as variceal bleeding and ascites. This study aimed to assess predictors of hepatic encephalopathy (HE) development and cumulative transplant-free survival after TIPS placement in patients with cirrhosis complicated by refractory ascites and major gastroesophageal bleeding.

Materials And Methods: Sixty-three cirrhotic patients who underwent TIPS positioning as a secondary prophylaxis of major upper gastroesophageal bleeding (N=30) or to control refractory ascites (N=33) were enrolled. Read More

Transpl Int 2019 04 21;32(4):343-352. Epub 2019 Feb 21.

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.

Kidney injury is frequently seen in patients with end-stage liver disease from cirrhosis and liver failure. Among selected patients, simultaneous liver kidney (SLK) transplantation provides improved post-transplant graft and patient outcomes compared to liver transplantation (LT) alone. We conducted the review of the existing literature on SLK transplant criteria and outcomes. Read More

Ann Ital Chir 2018 Dec 5;7. Epub 2018 Dec 5.

We present a case of a suspect splenic hematoma in an anticoagulated patient with an ignored diabetes mellitus, come to our emergency department. Lab tests showed increased CRP and INR, with an incoming hepatorenal syndrome. During the CT-scan the patient became unstable and the hemoglobin decreased. Read More

Arq Gastroenterol 2018 Jul-Sep;55(3):314-320

Hospital Português, Unidade de Gastroenterologia e Hepatologia, Salvador, BA, Brasil.

Acute kidney injury is a common complication of cirrhosis, occurring in up to 20% of patients hospitalized with cirrhosis. This field is rapidly changing, with significant advances in classification, biomarkers and therapy over the last few years. On the behalf of the Brazilian Society of Hepatology, a panel of experts in Hepatology and Nephrology reviewed published evidence to integrate findings and develop the recommendations presented in this manuscript. Read More

Curr Med Res Opin 2019 May 4;35(5):859-868. Epub 2019 Jan 4.

a Department of Gastroenterology , General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area) , Shenyang , China.

Hepatorenal syndrome (HRS) is a serious complication of liver cirrhosis, which is of pre-renal origin due to central volume depletion together with cardiac dysfunction and characterized by oliguria with severe urinary sodium retention and elevated serum creatinine levels. HRS is divided into HRS I, which is rapidly progressive and mostly seen in patients with decompensated liver cirrhosis, and HRS II, which progresses more slowly and is always accompanied by gross ascites. Liver transplantation is the best choice of treatment for HRS but rarely available. Read More

Lancet Gastroenterol Hepatol 2019 Jan 22;4(1):52-62. Epub 2018 Nov 22.

Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK.

Background: Liver disease is a major cause of mortality, with high numbers of hospital deaths, and disproportionately affects people younger than 65 years. This study aims to examine the place of death and factors associated with hospital death for people who died from liver disease.

Method: We did a national population-based, observational study using the National Death Registration Database from the Office for National Statistics, 2001-14. Read More

Hepatology 2018 Nov 24. Epub 2018 Nov 24.

"G. Fontana" Centre for the Study and Multidisciplinary Treatment of Alcohol Addiction, Department of Medical and Surgical Sciences, University of Bologna, Italy.

Between 14%-30% of the world's population is affected by alcohol use disorder (AUD), and excessive alcohol consumption represents the most common cause of liver disease in the western world. The clinical picture of alcoholic end-stage liver disease is rendered extremely complex, as manifestations such as alcohol withdrawal syndrome, craving and physical dependence, as well as extrahepatic alcohol-related diseases merge with the complications of advanced cirrhosis. This makes AUD recognition and assessment difficult and its management arduous as many drugs commonly used to treat complications such as alcohol withdrawal syndrome are often contraindicated by the presence of hepatic encephalopathy or hepatorenal syndrome. Read More

Clin Liver Dis 2019 02 26;23(1):81-98. Epub 2018 Oct 26.

Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, Recanati-Miller Transplantation Institute, One Gustave Levy Place, Box 1104, New York, NY 10029, USA. Electronic address:

Alcoholic hepatitis is a unique type of alcohol-associated liver disease characterized by acute liver inflammation caused by prolonged heavy alcohol use. Treatment is mostly supportive. The short-term prognosis of acute alcoholic hepatitis depends on liver recovery, and ranges widely from rapid improvement to grim multiorgan failure despite treatment. Read More

Metab Brain Dis 2019 02 15;34(1):213-221. Epub 2018 Nov 15.

Department of Gastroenterology, Liaocheng People's Hospital, Liaocheng, 252004, China.

Hepatic encephalopathy (HE) is a serious complication of liver disease. To establish a model for predicting 3-month mortality in patients with HE in China. This retrospective study included 609 patients with HE admitted to the Peoples' Hospital, Liaocheng City, China (August 2006 to January 2016). Read More

Aliment Pharmacol Ther 2018 Dec 11;48(11-12):1271-1281. Epub 2018 Nov 11.

Section Hepatology, Department of Gastroenterology and Rheumatology, University Hospital Leipzig, Leipzig, Germany.

Background: Loss of skeletal muscle mass is a recognised complication with a prognostic impact in patients with cirrhosis.

Aim: To explore in a retrospective analysis which muscle compartment most reliably predicts the occurrence of cirrhosis-associated complications and if there are gender-related differences.

Methods: 795 patients with cirrhosis listed for liver transplantation between 2001 and 2014 met the inclusion and exclusion criteria including an abdominal CT scan (±200). Read More

Hernia 2019 Feb 8;23(1):61-65. Epub 2018 Nov 8.

Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.

Purpose: Incisional hernia is a complication following abdominal operation. Patients undergoing liver transplantation have a high risk of developing incisional hernia because of immunosuppression. The purpose of this study was to evaluate incisional hernia after liver transplantation and to identify risk factors for hernia formation in those patients. Read More

Case Rep Nephrol Dial 2018 Sep-Dec;8(3):207-215. Epub 2018 Sep 27.

Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

Bile cast nephropathy (BCN) is seen in patients who have acute kidney injury and severe hyperbilirubinemia due to a wide range of hepatobiliary system diseases. Findings seen by renal biopsy include acute tubular injury with necrotic and sloughed epithelial cells, yellow-green pigment within tubular epithelial cells, and pigmented granular casts. Hall's special stain for bile turns these casts green. Read More