Assessing renal function in cirrhotic patients: Problems and pitfalls

Sherman, Deb S.; Fish, Douglas N.; Teitelbaum, Isaac

doi:10.1053/ajkd.2003.50035

Cited by 302 publications

(268 citation statements)

References 0 publications

Supporting

Mentioning

254

Contrasting

Unclassified

Order By: Relevance

“…An important criterion will be that such a novel marker performs better than the ICG clearance test, which is known to suffer from inaccuracy and limited reproducibility (Schneider, 2004). In regard to the MELD score, it should also be borne in mind that patients with cirrhosis potentially present with factors that lead to falsely low plasma creatinine values, which will overestimate the true glomerular filtration rate (Sherman et al, 2003). This will lower their MELD score and hence potentially lead to a too low priority rating on waiting lists.…”

Section: Perspectivementioning

confidence: 99%

The emerging role of transport systems in liver function tests

Stieger

Heger

Graaf

et al. 2012

European Journal of Pharmacology

View full text Add to dashboard Cite

Liver function tests are of critical importance for the management of patients with severe or terminal liver disease. They are also used as prognostic tools for planning liver resections. In recent years many transport systems have been identified that also transport substances employed in liver function tests. Such substances include endogenous bilirubin or exogenously administered indocyanine green, agents for magnetic resonance imaging, agents for single photon emission computed tomography or agents for breath tests. The increasing functional and molecular information on the respective transport systems should improve the management and as a result the outcome of patients scheduled for liver surgery or transplantation. To achieve the latter goal, clinical studies that assess individual patients' liver function over the course of their disease with liver function tests are needed to firmly establish and validate recently introduced and novel liver function markers. The emerging role of transport systems in liver function tests Bruno Stieger is supported by grant # 31003A_124652 from the Swiss National Science foundation. AbstractLiver function tests are of critical importance for the management of patients with severe or terminal liver disease. They are also used as prognostic tools for planning liver resections. In recent years many transport systems have been identified, that also transport substances employed in liver function tests. Such substances include endogenous bilirubin or exogenously administered indocyanine green, agents for magnetic resonance imaging, agents for single photon emission computed tomography or agents for breath tests. The increasing functional and molecular information on the respective transport systems should improve the management and as a result the outcome of patients scheduled for liver surgery or transplantation. To achieve the latter goal, clinical studies that assess individual patients liver function over the course of their disease with liver function testes are needed to firmly establish and validate recently introduced and novel liver function markers.

show abstract

Section: Perspectivementioning

confidence: 99%

The emerging role of transport systems in liver function tests

Stieger

Heger

Graaf

et al. 2012

European Journal of Pharmacology

View full text Add to dashboard Cite

show abstract

“…However, the IAC criteria had several limitations including a serum creatinine (SCr) of ≤1.5 mg/dL. This creatinine cut off excludes physiological fluctuations and a true estimate of glomerular filtration rate (GFR) [3]. In 2015, the IAC proposed a new definition of acute kidney injury (AKI) in cirrhosis.…”

Section: Discussionmentioning

confidence: 99%

“…Creatinine is a marker of filtration and can be used to detect a decline in kidney function, but lacks specificity. Serum creatinine in patients with cirrhosis may be influenced by increased volume of distribution, reduced production of endogenous creatinine, muscle wasting, medications and elevated bilirubin [3,6]. To date, the diagnosis of HRS is based solely upon clinical criteria and more discriminating tests are required to guide the allocation of treatment and to help predict progression of AKI.…”

Section: Discussionmentioning

confidence: 99%

Kidney Biomarkers in Hepatorenal Syndrome

Freeman¹

2017

GHOA

View full text Add to dashboard Cite

Cirrhosis is the result of advanced liver disease characterized by fibrosis due to increased portal hypertension. Patients with cirrhosis are prone to develop acute kidney injury (AKI) triggered by bacterial infections, hypovolemia, nephrotoxic drugs and intrinsic kidney disease. The diagnostic criteria for the diagnosis of HRS continue to rely on serum creatinine levels which should be interpreted with caution in patients with cirrhosis. To date, accurate biomarkers indicative of renal function are lacking. Further validation with prospective studies is warranted to evaluate the value of novel biomarkers.

show abstract

“…Several factors contribute to this such as decreased creatinine production due to decreased hepatic synthesis of creatinine, decreased skeletal muscle mass and increased tubular secretion of creatinine in cirrhotic patients. Calculated creatinine clearance may also overestimate the real glomerular filtration rate due to stated reasons (15).…”

Section: Definition Of Acute Kidney Injury In Cirrhosismentioning

confidence: 99%

Renal dysfunctions in cirrhosis

2016

View full text Add to dashboard Cite

Kidney dysfunction is a common and potentially life-threating event in patients with cirrhosis, and underlying mechanisms for renal dysfunction are quite variable. Acute kidney injury (AKI) is relatively frequent encountered in approximately 20% of hospitalized patients with cirrhosis. Nevertheless, chronic kidney disease (CKD) occurs in almost 1% of all patients with cirrhosis. In this review various renal problems encountered in cirrhotic patients are discussed and strategies to prevent renal dysfunction are suggested.

show abstract

Assessing renal function in cirrhotic patients: Problems and pitfalls

Cited by 302 publications

References 0 publications

The emerging role of transport systems in liver function tests

The emerging role of transport systems in liver function tests

Kidney Biomarkers in Hepatorenal Syndrome

Renal dysfunctions in cirrhosis

Contact Info

Product

Resources

About