Incidence and factors predictive of acute renal failure in patients with advanced liver cirrhosis

Wu, Chia‐Chao; Yeung, Ling; Tsai, W. S.; Tseng, C. F.; Chu, Peter; Huang, Ting; Lin, Yongbo; Lu, Kuo‐Cheng

doi:10.5414/cnp65028

Cited by 95 publications

(73 citation statements)

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“…Renal failure is associated with a high morbidity and mortality in patients with cirrhosis [1][2][3][4] . Cirrhotic patients may be particularly predisposed to renal failure because of intravascular volume depletion, hyperaldosteronism, and altered renal hemodynamics [5] .…”

Section: Introductionmentioning

confidence: 99%

“…Cirrhotic patients may be particularly predisposed to renal failure because of intravascular volume depletion, hyperaldosteronism, and altered renal hemodynamics [5] . Furthermore, aggressive use of diuretics, repeated large volume paracenteses, and gastrointestinal bleeding often contribute to renal insufficiency in these patients [1,2] . Contrast-induced nephropathy (CIN) is a common cause of renal failure, and is associated with substantial morbidity and mortality [6][7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

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Risk of contrast-induced nephropathy in hospitalized patients with cirrhosis

Lodhia¹,

Kader²,

Mayes³

et al. 2009

WJG

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AIM:To evaluate the incidence of contrast-induced nephropathy (CIN) in cirrhotic patients and to identify risk factors for the development of CIN. METHODS:We performed a retrospective review of 216 consecutive patients with cirrhosis who underwent computed tomography (CT) with intravenous contrast at the University of Rochester between the years 2000-2005. We retrospectively examined factors associated with a high risk for CIN, defined as a decrease in creatinine clearance of 25% or greater within one week after receiving contrast. RESULTS:Twenty-five percent of our patients developed CIN, and 74% of these patients had ascites seen on CT. Of the 75% of patients who did not develop CIN, only 46% had ascites. The presence of ascites was a significant risk factor for the development of CIN (P = 0.0009, OR 3.38, 95% CI 1.55-7.34) in multivariate analysis. Patient age, serum sodium, Model for End-stage Liver Disease score, diuretic use, and the presence of diabetes were not found to be significant risk factors for the development of CIN. Of the patients who developed CIN, 11% developed chronic renal insufficiency, defined as a creatinine clearance less than baseline for 6 wk. CONCLUSION:Our results suggest that in hospitalized cirrhotic patients, especially those with ascites, the risk of CIN is substantial.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk of contrast-induced nephropathy in hospitalized patients with cirrhosis

Lodhia¹,

Kader²,

Mayes³

et al. 2009

WJG

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“…Volume overload is the main factor of HT that leads to CVD [1]. Hyponatremia is also reported to be associated with increased morbidity and mortality in various diseases, including CKD [8][9][10][11]. Therefore, both volume overload and hyponatremia should be corrected in CKD.…”

Section: Discussionmentioning

confidence: 99%

Successful treatment with tolvaptan to control blood volume and hyponatremia in a chronic kidney disease patient

et al. 2012

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We report a case of successful treatment with tolvaptan (15 mg/day) in a 73-year-old female patient with chronic kidney disease (CKD) stage 5 due to diabetic nephropathy and renal sclerosis for volume control and loop diuretic-induced hyponatremia. Her creatinine clearance has remained at 7-10 ml/min for the last 6 months. She was treated by dietary and drug therapy, namely, antihypertensives (nifedipine: 40 mg/day, olmesartan: 20 mg/ day) and loop diuretics (azosemide: 40-120 mg/day), for CKD and concomitant diseases of hypertension and diabetic mellitus. She developed loop diuretic-induced hyponatremia (120 mmol/l) by increased sodium excretion, but the diuretic was required for the control of volume overload. Hence, azosemide was suspended and tolvaptan (15 mg/day) was administered. After tolvaptan treatment, the plasma sodium level gradually increased to a normal level (135-140 mmol/l) and volume overload was improved. Urine volume was maintained at about 1000 ml/ day with low sodium excretion (\40 mmol/day) and increased free water clearance. These results suggest that tolvaptan may be effective for volume control and diureticinduced hyponatremia in CKD patients.

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“…Infections-induced RI: when an overt infection was diagnosed on a solid clinical, laboratory, and/or imaging findings. Spontaneous bacterial peritonitis (SBP) was defined by polymorphonuclear count greater than 250 per mm 3 in ascitic fluid in the absence of a source of infection in the peritoneal cavity (8); spontaneous bacteremia was defined by positive blood cultures without an evidence of infection. 2.…”

Section: Study Definitionsmentioning

confidence: 99%

“…The real incidence and the different etiologies may have a great burden on the prognosis and the outcome. It has been known for many years that patients have a reduced survival than patients without renal failure (3). Liver and renal dysfunction often present together, either secondary to single organ failure or as part of multi-organ failure.…”

Section: Introductionmentioning

confidence: 99%

Incidence, causes, and outcomes of renal failure among cirrhotic patients

Kh¹,

Ma²,

Mo³

et al. 2015

Turk J Gastroenterol

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Background/Aims: To evaluate the incidence, risk factors of RF among cirrhotic and its impact on patient's outcome. Materials and Methods: A total of 573 cirrhotic patients were evaluated for renal failure (RF) and its causes, 212 patients (37%) were enrolled. Results: Majority of the patients had post hepatitis C liver disease (n=190, 89.6%) with Child-Pugh score C (88.2%), HCC was in 21.2% of cases baseline characteristics. Infections were observed in 45.8% (n=97) of patients whereas, spontaneous bacterial peritonitis (SBP) was the most type of infection (19.3%) among cirrhotic patients with renal failure, followed by pneumonia (9.9%). Infection-induced represents 30.2% followed by hypovolemia (29.7%), whereas HRS was in 11.3%. Reversibility of the condition was seen in 81 patients (38.2%), whereas mortality was seen in 58 (27.4%) patients of RF. The reversibility was more common in the patients with infection, followed by hypovolemia. Mortality was higher in the patients with HRS followed by parenchymal renal disease. Conclusion: Infection-induced and hypovolemic-induced RF represent the most common and also the most correctable causes and must be considered in management protocols for early detection and treatment that will serve for a better prognosis.

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Incidence and factors predictive of acute renal failure in patients with advanced liver cirrhosis

Cited by 95 publications

References 0 publications

Risk of contrast-induced nephropathy in hospitalized patients with cirrhosis

Risk of contrast-induced nephropathy in hospitalized patients with cirrhosis

Successful treatment with tolvaptan to control blood volume and hyponatremia in a chronic kidney disease patient

Incidence, causes, and outcomes of renal failure among cirrhotic patients

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