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AKI liver

Sang Jun Han, Hongmei Li, Mihwa Kim, Vivette D'Agati, H Thomas Lee
Intestinal Paneth cells play a critical role in ischemic acute kidney injury (AKI) by releasing interleukin 17A (IL-17A). Because Toll-like receptor 9 (TLR9) activation degranulates Paneth cells and necrotic tubular epithelial cells release several damage associated molecular patterns that target TLR9, we tested the hypothesis that intestinal TLR9 deficiency would protect against ischemic AKI and associated remote intestinal and hepatic dysfunction by decreasing Paneth cell degranulation. We generated mice lacking TLR9 in intestinal epithelia (TLR9fl/fl Villin Cre mice) and compared them to wild type (TLR9fl/fl) mice following right nephrectomy and left ischemia/reperfusion...
February 15, 2019: Kidney International
Mattias Mandorfer, Manfred Hecking
In this issue of Hepatology, Bräsen and Mederacke et al (1) present an analysis of all kidney biopsies performed at the gastroenterology and hepatology department at Hannover Medical School over a 16-year period. The authors identified 79 patients with both liver disease and impaired renal function, 57% of whom had acute kidney injury (AKI) or AKI overlapping chronic kidney disease (CKD), while 43% had CKD, as defined by the recently updated European clinical practice guidelines. Interestingly, 8 patients were diagnosed with cholemic nephropathy (CN), who all presented as AKI...
February 11, 2019: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Risto O Juvonen, Filip Novák, Eleni Emmanouilidou, Seppo Auriola, Juri Timonen, Aki T Heikkinen, Jenni Küblbeck, Moshe Finel, Hannu Raunio
Scoparone, a major constituent of the Chinese herbal medicine Yin Chen Hao, expresses beneficial effects in experimental models of various diseases. The intrinsic doses and effects of scoparone are dependent on its metabolism, both in humans and animals. We evaluated in detail the metabolism of scoparone in human, mouse, rat, pig, dog, and rabbit liver microsomes in vitro and in humans in vivo . Oxidation of scoparone to isoscopoletin via 6-O-demethylation was the major metabolic pathway in liver microsomes from humans, mouse, rat, pig and dog, whereas 7-O-demethylation to scopoletin was the main reaction in rabbit...
February 8, 2019: Planta Medica
Jacqueline G O'Leary, Jasmohan S Bajaj, Puneeta Tandon, Scott W Biggins, Florence Wong, Patrick S Kamath, Guadalupe Garcia-Tsao, Benedict Maliakkal, Jennifer Lai, Michael Fallon, Hugo E Vargas, Paul Thuluvath, Ram Subramanian, Leroy R Thacker, Rajender K Reddy
Acute-on-Chronic Liver Failure (ACLF) characterized with ≥2 extra-hepatic organ failures in cirrhosis carries a high mortality. Outcomes of patients listed for liver transplant (LT) after ACLF and after LT are largely unknown. NACSELD (North American Consortium for the Study of End-Stage Liver Disease) prospectively enrolled 2,793 non-electively hospitalized patients with cirrhosis; 768 were LT-listed. Within 3-months 265 (34%) received a LT, 395 remained alive without LT, and 108 died/delisted. Compared to non-listed patients, those listed were younger, more often had ACLF, AKI, and a higher admission MELD...
February 5, 2019: Liver Transplantation
Won Ho Kim, Hye-Won Oh, Seong-Mi Yang, Je Hyuk Yu, Hyung-Chul Lee, Chul-Woo Jung, Kyung-Suk Suh, Kook Hyun Lee
BACKGROUND: Acute kidney injury (AKI) after living donor liver transplantation (LDLT) is associated with increased mortality. We sought to identify associations between intraoperative hemodynamic variables and postoperative AKI. METHODS: We retrospectively reviewed 734 cases of LDLT. Intraoperative hemodynamic variables of systemic and pulmonary arterial pressure, central venous pressure (CVP), and pulmonary artery catheter-derived parameters including mixed venous oxygen saturation (SvO2), right ventricular end-diastolic volume (RVEDV), stroke volume, systemic vascular resistance, right ventricular ejection fraction, and stroke work index were collected...
January 30, 2019: Transplantation
Giuseppe Cullaro, Elizabeth C Verna, Jennifer C Lai
BACKGROUND & AIMS: Renal dysfunction increases risk of death for patients with cirrhosis. We investigated whether mortality differs significantly among patients with acute kidney injury (AKI), chronic kidney disease (CKD), and both. METHODS: We performed a retrospective analysis of all non-status 1 adults on the waitlist for liver transplantation for at least 90 days, collected from the Organ Procurement and Transplantation Network registry from July 1, 2007 through July 1, 2014...
February 1, 2019: Clinical Gastroenterology and Hepatology
Ryoko Tajima, Takeshi Kimura, Ayaka Enomoto, Aki Saito, Satomi Kobayashi, Katsunori Masuda, Kaoruko Iida
OBJECTIVE: It has been hypothesized that fruit and vegetable intake is inversely associated with non-alcoholic fatty liver (NAFLD). However, some studies have speculated that fruit intake might be positively associated with NAFLD owing to the fructose content of the fruit. This might cause consumers to hesitate consuming fruit. The aim of this study was to assess the association between fruit and vegetable consumption and NAFLD. METHODS: This was a cross-sectional study of 977 men and 1467 women, 40 to 69 y of age without current liver disease other than NAFLD and who did not report excess alcohol intake (i...
October 23, 2018: Nutrition
Michael Schmitz, Peter J Heering
Acute kidney injury (AKI) can be considered as an inflammatory systemic disorder affecting virtually every organ. It has great impact on morbidity and mortality of critically ill patients. DIAGNOSTIC:  The use of electronic alerts for detection of AKI combined with the use of standardized kidney care bundles can improve patient outcomes. Currently, it is important to find ways to implement these in everyday clinical practice. PREVENTION/CONSERVATIVE THERAPY:  Volume replacement therapy should always be carried out with balanced solutions...
February 2019: Deutsche Medizinische Wochenschrift
Andrew J MacDonald, Mitra K Nadim, François Durand, Constantine J Karvellas
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. RECENT FINDINGS: Biomarkers (neutrophil gelatinase-associated lipocalin, kidney injury molecule-1, interleukin-18, and liver-type fatty acid-binding protein) may assist in the identification of underlying acute tubular necrosis...
January 22, 2019: Current Opinion in Critical Care
Elhanan Nahum, Gili Kadmon, Eytan Kaplan, Avichai Weissbach, Hanan Hijazi, Orly Haskin, Yael Mozer-Glassberg
PURPOSE: To compare the application of three standardized definitions of acute kidney injury (AKI), using corrected serum creatinine values, in children immediately after liver transplantation. METHODS: Retrospective search of a tertiary pediatric hospital database yielded 77 patients (age < 18 years) who underwent liver transplantation in 2007-2017. Serum creatinine levels during the 24 h before and after surgery were corrected to daily fluid balance, and the prevalence of AKI was calculated using the Pediatric RIFLE (pRIFLE), AKI Network (AKIN), and Kidney Disease Improving Global Outcomes (KDIGO) criteria...
April 2019: Journal of Critical Care
Victoria E Blanco, Carolina V Hernandorena, Paula Scibona, Waldo Belloso, Carlos G Musso
Acute kidney injury (AKI) is a common problem in hospitalized patients that is associated with significant morbid-mortality. The impact of kidney disease on the excretion of drugs eliminated by glomerular filtration and tubular secretion is well established, as well as the requirement for drug dosage adjustment in impaired kidney function patients. However, since impaired kidney function is associated with decreased activity of several hepatic and gastrointestinal drug-metabolizing enzymes and transporters, drugs doses adjustment only based on kidney alteration could be insufficient in AKI...
January 14, 2019: Healthcare (Basel, Switzerland)
Chitta Ranjan Khatua, Subhendu Panigrahi, Debakanta Mishra, Subhasis Pradhan, Saroj Kanta Sahu, Rakesh Kumar Barik, Prasanta Kumar Parida, Sambit Behera, Suryakanta Parida, Shivaram Prasad Singh
Background and Aims: Acute kidney injury (AKI) occurs commonly in patients with acute-on-chronic liver failure (ACLF). However, there are scant data regarding the impact of AKI on survival in ACLF. We performed a prospective study to evaluate the impact of AKI on survival in ACLF. Methods: This study was conducted in ACLF patients hospitalized in the Gastroenterology Department of Sriram Chandra Bhanja Medical College (India) between October 2016 and February 2018. Demographic, clinical and laboratory parameters were recorded, and outcomes were compared between patients with and without AKI and between patients with persistent AKI and AKI reversal at 48 h...
December 28, 2018: Journal of Clinical and Translational Hepatology
Jan Hinrich Bräsen, Young-Seon Mederacke, Jessica Schmitz, Kateryna Diahovets, Abedalrazag Khalifa, Björn Hartleben, Fermín Person, Thorsten Wiech, Eric Steenbergen, Anika Großhennig, Michael P Manns, Roland Schmitt, Ingmar Mederacke
Impairment of renal function often occurs in patients with liver disease. Hepatorenal syndrome is a significant cause of acute kidney injury (AKI) in cirrhotic patients (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. As data on patients with CN is mostly obtained from case reports or autopsy studies, we aimed to investigate the frequency and clinical course of CN. We identified 149 patients who underwent kidney biopsy between 2000 to 2016 at the Department of Gastroenterology, Hepatology and Endocrinology...
January 11, 2019: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Kensuke Mohri, Hirofumi Misu, Hiroaki Takayama, Kiyo-Aki Ishii, Akihiro Kikuchi, Fei Lan, Yasufumi Enyama, Yumie Takeshita, Yoshiro Saito, Shuichi Kaneko, Toshinari Takamura
A hepatokine is a collective term for liver-derived secretory factors whose previously-unrecognized functions have been recently elucidated. We have rediscovered selenoprotein P (SeP) and leukocyte cell-derived chemotaxin 2 (LECT2) as hepatokines that are involved in the development of insulin resistance and hyperglycemia. The aim of this study was to determine whether and, if so, how oral glucose loading alters the two hepatokines in humans. We measured concentrations of serum SeP and plasma LECT2 during 75g oral glucose tolerance test (OGTT) (n = 20) in people with various degrees of glucose tolerance...
December 28, 2018: Biological & Pharmaceutical Bulletin
Won Ho Kim, Hyung-Chul Lee, Leerang Lim, Ho-Geol Ryu, Chul-Woo Jung
Acute kidney injury (AKI) is a frequent complication after living donor liver transplantation (LDLT), and is associated with increased mortality. However, the association between intraoperative oliguria and the risk of AKI remains uncertain for LDLT. We sought to determine the association between intraoperative oliguria alone and oliguria coupled with hemodynamic derangement and the risk of AKI after LDLT. We evaluated the hemodynamic variables, including mean arterial pressure, cardiac index, and mixed venous oxygen saturation (SvO₂)...
December 28, 2018: Journal of Clinical Medicine
Cristina Solé, Elsa Solà, Patricia Huelin, Marta Carol, Rebeca Moreira, Unai Cereijo, José-Manuel Mas, Isabel Graupera, Elisa Pose, Laura Napoleone, Gloria dePrada, Adrià Juanola, Núria Fabrellas, Ferran Torres, Manuel Morales-Ruiz, Judith Farrés, Wladimiro Jiménez, Pere Ginès
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. AIM AND METHODS: To characterize the systemic inflammatory response, as estimated by measuring a large number of cytokines, in 161 patients hospitalized for an acute decompensation of cirrhosis: 44 patients without acute kidney injury (AKI), 63 patients with hypovolaemia-induced AKI and 58 patients with HRS-AKI...
December 29, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
Ranjani Ravi, Kedar Suthar, Praveen Murlidharan, K Lakshmi, Satish Balan, Mohammed Safeer
Hepatitis A is usually a benign self-limiting disease with few or no extrahepatic manifestations. Acute hepatitis A causing severe renal dysfunction is not very common, although described. Patients developing renal dysfunction post hepatitis A infection usually have prerenal acute kidney injury (AKI) or acute tubular necrosis due to vomiting, diarrhea, and poor fluid replacement. However, if renal dysfunction persists, other causes need to be evaluated. The term cholemic nephrosis or more specifically bile cast nephropathy has been described in the setting of cholestatic jaundice and decompensated liver failure where bilirubin levels reach above 20 mg/dL...
November 2018: Saudi Journal of Kidney Diseases and Transplantation
Susan Mohammadi Kebar, Saeed Hosseini Nia, Nasrollah Maleki, Afshan Sharghi, Arash Sheshgelani
Background: Acute kidney injury (AKI) is the most common cause of organ dysfunction in intensive care unit (ICU) patients. There is no consensus definition of AKI in ICU patients. Therefore, we aimed to evaluate the incidence rate, risk factors and clinical outcome of AKI using the RIFLE (Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease) classification in ICU patients. Methods: We performed a retrospective cohort study, on 900 patients admitted to the ICU during a one year period at Imam Khomeini Hospital in Ardebil, Iran from 2014 to 2015...
November 2018: Iranian Journal of Public Health
R M Hanna, U Selamet, H Hasnain, M El-Masry, S Saab, W D Wallace, B Yanny, J Wilson
Transplant patients are at risk for hemodynamic injury and glomerular diseases such as focal segmental glomerulosclerosis (FSGS) and thrombotic microangiopathy (TMA). Calcineurin inhibitors (CNI) can cause various patterns of acute kidney injury (AKI) in transplant patients and their effects must be differentiated from kidney injury due to other agents. Transplant populations are also at risk for atypical infections and malignancies. These conditions and the agents that are used to treat them can then induce their own set of glomerular diseases...
December 2018: Transplantation Proceedings
Shinji Takasu, Yuh Yokoo, Yuji Ishii, Aki Kijima, Kumiko Ogawa, Takashi Umemura
Long-term exposure to piperonyl butoxide (PBO) induces multiple nodular masses along with hepatocellular tumors in the liver of mice. The histopathological features of the nodules led to our diagnosis of nodular regenerative hepatocellular hyperplasia (NRH). However, because of the lack of data on the biological characteristics of NRH, whether this lesion is truly nonneoplastic remains unknown. In this study, the molecular characteristics of NRH were compared with those of hepatocellular adenoma (HCA) by global gene expression analysis...
December 20, 2018: Toxicologic Pathology
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