Untitled

Cassinello, Concepción; Moreno, Enrique; Gozalo, A.; B, Ortuño; Cuenca, B. de; Solı́s-Herruzo, José A.

doi:10.1023/a:1021763221337

Cited by 39 publications

(7 citation statements)

References 58 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…HRS physiology is thought to be an extreme pre-renal state ( 29 , 30 ) with severe renovascular vasoconstriction and decreased GFR, but normal intrinsic kidney function. Kidney function can return to normal after improvement of hepatic hemodynamics ( 29 , 30 , 31 ), or after renal transplantation into a recipient with normal hepatic function ( 32 , 33 ).…”

Section: Discussionmentioning

confidence: 99%

Urinary Biomarkers of Acute Kidney Injury in Patients With Liver Cirrhosis

Fs²,

Emad³

et al. 2014

Med Arh

View full text Add to dashboard Cite

Background and aim:Acute kidney injury is a common complication in cirrhotic patients. Serum creatinine is a poor biomarker for detection of renal impairment in cirrhotic patients. The aim of this study was to evaluate Urinary Neutrophils Gelatinase-Associated Lipocalin (NGAL) and Urinary interleukin-18 (IL-18) as early biomarkers of acute kidney injury in cirrhotic patients.Patients and methods:160 cirrhotic patients was enrolled in this study divided into 3 main groups according to presence or absence of ascites and renal impairment. Results:Significant elevation of both Urinary NGAL and Urinary IL-18 in cirrhotic patients with renal impairment especially in patients with Acute tubular necrosis (ATN) was observed. AUROC was (0.909) with (sensitivity 95.5 %, specificity 76.1) for Urinary NGAL and AUROC was (0.975), with (sensitivity 95.5 %, specificity 91.3 %) for Urinary IL-18.Conclusion:both Urinary NGAL and Urinary IL-18 can act as urinary biomarkers of acute kidney injury in cirrhotic patient

show abstract

Section: Discussionmentioning

confidence: 99%

Urinary Biomarkers of Acute Kidney Injury in Patients With Liver Cirrhosis

Fs²,

Emad³

et al. 2014

Med Arh

View full text Add to dashboard Cite

show abstract

“…Kidney function can return to normal after improvement of hepatic hemodynamics (i.e. TIPS, surgical portal-caval shunts and liver transplant),[6, 7, 35–40] or after transplantation of the kidney into a recipient with normal hepatic function. [6, 8] However, pathologic investigations have reported subtle kidney tubular and glomerular damage in HRS kidneys, some seen only with electron microscopy,[11, 41] perhaps resulting from the cellular changes associated with chronic activation of angiotensin-aldosterone signaling.…”

Section: Discussionmentioning

confidence: 99%

Urinary Neutrophil Gelatinase-Associated Lipocalin Predicts Mortality and Identifies Acute Kidney Injury in Cirrhosis

et al. 2012

View full text Add to dashboard Cite

Background Kidney failure predicts mortality in patients with cirrhosis. Identification of kidney failure etiology and recognition of those at the highest mortality risk remains a challenge. Aims We hypothesized that urinary Neutrophil Gelatinase-Associated Lipocalin (uNGAL) predicts mortality and identifies hepatorenal syndrome (HRS) in patients with cirrhosis. Methods Prospectively enrolled patients with cirrhosis were investigated by uNGAL immunoblot upon hospital admission. Kidney failure type was determined blinded to NGAL measurements. Results One hundred and eighteen patients were enrolled. Fifty-two (44%) patients had normal kidney function, 14 (12%) stable chronic kidney disease, 17 (14%) prerenal azotemia, 20 (17%) HRS, and 15 (13%) intrinsic acute kidney injury (iAKI). Patients with HRS had uNGAL levels intermediate between prerenal azotemia [median (IQR) 105 (27.5–387.5) v. 20 (15–45) ng/ml, p=0.004] and iAKI [325 (100–700), p<0.001]. Fifteen (13%) patients died. In unadjusted analysis, uNGAL predicted inpatient mortality (OR 2.00, 95% CI 1.36–2.94) and mortality or liver transplantation (OR 2.01, 95% CI 1.42–2.85). In multiple regression models, uNGAL>110 ng/ml (OR 6.05, 95% CI 1.35–27.2) and HRS (OR 6.71, 95% CI 1.76–25.5) independently predicted mortality, adjusting for age and serum creatinine>1.5 mg/dL. Conclusions uNGAL strongly predicts short term inpatient mortality in both unadjusted and adjusted models. Patients with HRS may have uNGAL levels intermediate between those with prerenal azotemia and iAKI. Further studies are needed to determine if uNGAL can improve discrimination of HRS from other types of acute kidney injury and predict short- and long-term cirrhosis outcomes.

show abstract

“…HRS physiology is thought to be an extreme prerenal state [27, 28] with severe renovascular vasoconstriction and decreased GFR, but normal intrinsic kidney function. Kidney function can return to normal after improvement of hepatic hemodynamics [27–29] or after renal transplantation into a recipient with normal hepatic function [30, 31]. …”

Section: Discussionmentioning

confidence: 99%

Urinary Biomarkers of Acute Kidney Injury in Patients with Liver Cirrhosis

et al. 2014

View full text Add to dashboard Cite

Acute kidney injury (AKI) is a common complication in cirrhotic patients. Serum creatinine is a poor biomarker for detection of renal impairment in cirrhotic patients. This study aimed to evaluate urinary neutrophil gelatinase-associated lipocalin (NGAL) and urinary interleukin-18 (IL-18) as early biomarkers of acute kidney injury in cirrhotic patients. 160 patients with cirrhosis admitted to the Liver Units at Zagazig University Hospitals were classified into three groups: (I) nonascitic patients, (II) ascitic patients without renal impairment, and (III) ascitic patients with renal impairment. Patients with renal impairment were further divided into four subgroups: [A] prerenal azotemia, [B] chronic kidney disease (CKD), [C] hepatorenal syndrome (HRS), and [D] acute tubular necrosis (ATN). Significant elevation of both urinary NGAL and urinary IL-18 in cirrhotic patients with renal impairment especially in patients with ATN was observed. Urinary NGAL and urinary IL-18 have the ability to differentiate between AKI types in patients with cirrhosis. This could improve risk stratification for patients admitted to the hospital with cirrhosis, perhaps leading to early ICU admission, transplant evaluation, and prompt initiation of HRS therapy and early management of AKI.

show abstract

Untitled

Cited by 39 publications

References 58 publications

Urinary Biomarkers of Acute Kidney Injury in Patients With Liver Cirrhosis

Urinary Biomarkers of Acute Kidney Injury in Patients With Liver Cirrhosis

Urinary Neutrophil Gelatinase-Associated Lipocalin Predicts Mortality and Identifies Acute Kidney Injury in Cirrhosis

Urinary Biomarkers of Acute Kidney Injury in Patients with Liver Cirrhosis

Contact Info

Product

Resources

About