KASL Clinical Practice Guidelines: Management of Alcoholic Liver Disease

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doi:10.3350/cmh.2013.19.3.216

Cited by 30 publications

(21 citation statements)

References 327 publications

(328 reference statements)

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“…In patients with severe alcoholic hepatitis, Maddrey's DF and MELD scores are useful to estimate short term prognosis and guide treatment decisions ( 2 ). Glasgow alcoholic hepatitis score and ABIC (Age, Bilirubin, INR, Creatinine) score also show promise as prognosis predictive models for alcoholic hepatitis ( 2 ). A Korean study has demonstrated that the Maddrey's DF score has superior prognosis prediction ability for alcoholic hepatitis, with comparable results to that from the MELD score ( 3 ).…”

Section: Discussionmentioning

confidence: 99%

“…We retrospectively analyzed data of a total of 544 admissions from 409 patients who were consecutively admitted to Chonbuk National University Hospital and diagnosed with ALD between January 2010 and December 2012. The diagnosis of ALD in patients was based on the following: daily alcohol consumption exceeding 40 g in men and 20 g in women, with clinical, laboratory, radiological, or histological evidence of liver disease ( 2 ). Currently there was no definite diagnostic criteria for alcoholic hepatitis.…”

Section: Methodsmentioning

confidence: 99%

“…Alcohol abuse can lead to alcoholic liver disease (ALD) including fatty liver, hepatitis, cirrhosis, and liver cancer ( 1 ). Alcohol is the second common cause of chronic liver disease, accounting for approximately 25%-30% cases of liver cirrhosis in Korea ( 2 ). Although fatty liver can be reversed after abstinence of alcohol, alcoholic hepatitis and cirrhosis are usually progressive and sometimes fatal.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Characteristics and Prognostic Impact of Bacterial Infection in Hospitalized Patients with Alcoholic Liver Disease

et al. 2015

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Bacterial infection is an important cause of death in patients with liver cirrhosis. The aim of this study was to investigate the clinical characteristics and prognostic impact of bacterial infection in hospitalized patients with alcoholic liver disease (ALD). We retrospectively analyzed data from 409 patients consecutively admitted to a tertiary referral center with ALD diagnosis. Of a total of 544 admissions, 133 (24.4%) cases presented with bacterial infection, of which 116 were community-acquired whereas 17 were hospital-acquired. The common types of infection were pneumonia (38%), biliary tract infection (17%), soft tissue infection (12%), and spontaneous bacterial peritonitis (9%). Diabetes, serum Na <135 mM/L, albumin <2.5 g/dL, C-reactive protein ≥20 mg/L, systemic inflammatory response syndrome (SIRS) positivity were independently associated with bacterial infection in patients with ALD. Overall 30-day and 90-day mortalities in patients with bacterial infection were significantly (P < 0.001) higher than those without infection (22.3% vs. 5.1% and 32.3% vs. 8.2%, respectively). Furthermore, bacterial infection (HR, 2.2; 95% CI, 1.049-4.579, P = 0.037), SIRS positivity (HR, 2.5; 95% CI, 1.240-4.861, P = 0.010), Maddrey's discriminant function score ≥32 (HR, 2.3; 95% CI, 1.036-5.222, P = 0.041), and hemoglobin <12 g/dL (HR, 2.4; 95% CI, 1.081-5.450, P = 0.032) were independent predictors of short-term mortality. In conclusion, bacterial infection and SIRS positivity predicted short-term prognosis in hospitalized patients with ALD. A thorough evaluation at admission or on clinical deterioration is required to detect possible infection with prompt management.Graphical Abstract

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical Characteristics and Prognostic Impact of Bacterial Infection in Hospitalized Patients with Alcoholic Liver Disease

et al. 2015

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“…HCV or HBV infection was diagnosed by serological detection of HCV antibodies and HBV surface antigen, respectively 21,22. Alcoholic liver disease was defined as a disease associated with consumption of ≥40 g alcohol daily for ≥5 years 23. Other diseases were diagnosed using currently recognized criteria 24,25…”

Section: Methodsmentioning

confidence: 99%

Relationship between 25-Hydroxyvitamin D Levels and Liver Fibrosis as Assessed by Transient Elastography in Patients with Chronic Liver Disease

Kim

et al. 2016

Gut and Liver

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Background/AimsDeficiencies of 25-hydroxyvitamin D (25(OH)D) are prevalent in patients with chronic liver disease (CLD). Liver fibrosis is the main determinant of CLD prognosis. The present study was performed to evaluate the correlation between 25(OH)D levels and liver fibrosis as assessed by transient elastography (TE) in patients with compensated CLD.MethodsSerum 25(OH)D levels and liver stiffness were determined in a total of 207 patients who were subjected to the following exclusion criteria: patients with decompensated CLD; patients who had malignancies; patients who were taking medications; and patients who were pregnant.ResultsThe most common etiology was chronic hepatitis B (53.1%). Advanced liver fibrosis (defined by TE [≥9.5 kPa]) was present in 75 patients (36.2%). There was a significant correlation between 25(OH)D deficiency and liver stiffness. Based on the multivariate analysis, the following factors were independently associated with advanced liver fibrosis: 25(OH)D deficiency (odds ratio [OR], 3.46; p=0.004), diabetes mellitus (OR, 3.04; p=0.041), and fibrosis-4 index (OR, 2.01; p<0.001).ConclusionsPatients with compensated CLD exhibit a close correlation between vitamin D level and liver stiffness as assessed by TE. Vitamin D deficiency was independently associated with advanced liver fibrosis.

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“…Alcoholic liver disease (ALD) is a leading cause of liver-related deaths worldwide. The chronic spectrum of alcohol-ingestion-related diseases includes steatosis, steatohepatitis, cirrhosis, and hepatocellular carcinoma [1–3] . Bacterial translocation due to disruption of the gut-barrier function by alcohol induces endotoxemia [4] .…”

Section: Introductionmentioning

confidence: 99%

Effects of Korean Red Ginseng (Panax ginseng), urushiol (Rhus vernicifera Stokes), and probiotics (Lactobacillus rhamnosus R0011 and Lactobacillus acidophilus R0052) on the gut–liver axis of alcoholic liver disease

Bang

Hong

Suk

et al. 2014

Journal of Ginseng Research

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BackgroundRoles of immune reaction and toll-like receptor-4 (TLR-4) have widely been established in the pathogenesis of alcoholic liver disease (ALD).MethodsWe evaluated the biologic efficacy of Korean Red Ginseng (KRG), urushiol, and probiotics (Lactobacillus rhamnosus R0011 and Lactobacillus acidophilus R0052) in mouse models of ALD. Sixty C57BL/6 mice were equally divided into six feeding groups for 10 weeks: normal diet, alcohol, control, alcohol + KRG, alcohol + urushiol, and alcohol + probiotics. Alcohol was administered via a Lieber–DeCarli liquid diet containing 10% alcohol. TLR-4 expression, proinflammatory cytokines, and histology, as well as the results of liver function tests were evaluated and compared.ResultsNo between-group differences were observed with regard to liver function. TLR-4 levels were significantly lower in the KRG, urushiol, and probiotics groups than in the alcohol group (0.37 ± 0.06 ng/mL, 0.39 ± 0.12 ng/mL, and 0.33 ± 0.07 ng/mL, respectively, vs. 0.88 ± 0.31 ng/mL; p < 0.05). Interleukin-1β levels in liver tissues were decreased among the probiotics and KRG groups. The tumor necrosis factor-α level of liver tissue was decreased in the KRG group.ConclusionThe pathological findings showed that alcohol-induced steatosis was significantly reduced by KRG and urushiol. As these agents improve immunologic capacity, they may be considered in potential anti-ALD treatments.

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KASL Clinical Practice Guidelines: Management of Alcoholic Liver Disease

Cited by 30 publications

References 327 publications

Clinical Characteristics and Prognostic Impact of Bacterial Infection in Hospitalized Patients with Alcoholic Liver Disease

Clinical Characteristics and Prognostic Impact of Bacterial Infection in Hospitalized Patients with Alcoholic Liver Disease

Relationship between 25-Hydroxyvitamin D Levels and Liver Fibrosis as Assessed by Transient Elastography in Patients with Chronic Liver Disease

Effects of Korean Red Ginseng (Panax ginseng), urushiol (Rhus vernicifera Stokes), and probiotics (Lactobacillus rhamnosus R0011 and Lactobacillus acidophilus R0052) on the gut–liver axis of alcoholic liver disease

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