Natural History of Patients Hospitalized for Management of Cirrhotic Ascites

Planas, Ramón; Montoliu, Silvia; Ballesté, Belen; Rivera, Mònica; Miquel, Mireia; Masnou, Helena; Galeras, Jose Antonio; Gimenez, Maria Dolores; Santos, J.; Cirera, Isabel; Morillas, Rosa María; Coll, Susanna; Solá, Ricard

doi:10.1016/j.cgh.2006.08.007

Cited by 347 publications

(275 citation statements)

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“…1 Ascites usually develops within 10 years during the course of the disease in the 60% of the patients with compensated cirrhosis, 2 and it is associated with poor prognosis with a rate of mortality of approximately 40% after 1 year. [3][4][5][6][7] The related factors for mortality prediction in patients with ascites include hyponatremia, high serum creatinine and low arterial blood pressure. [3][4][5][6][7][8][9] These patients also have high risk for other complications such as spontaneous bacterial peritonitis (SBP), hyponatremia and hepatorenal syndromes, which increase the risk of fatal outcome.…”

Section: Introductionmentioning

confidence: 99%

“…[3][4][5][6][7] The related factors for mortality prediction in patients with ascites include hyponatremia, high serum creatinine and low arterial blood pressure. [3][4][5][6][7][8][9] These patients also have high risk for other complications such as spontaneous bacterial peritonitis (SBP), hyponatremia and hepatorenal syndromes, which increase the risk of fatal outcome. 1,3,[7][8][9][10][11][12][13][14][15][16] Several scores have been developed in order to predict severity of the disease and prognosis in order to consider liver transplantation as a potential treatment option.…”

Section: Introductionmentioning

confidence: 99%

“…2 These scores are Child Turcotte Pugh and MELD; however, they were designed for predicting liver transplantation requirements and mortality in the short term, but not while in hospital. 3,[14][15][16][17][18][19][20][21] The present study was carried out in order to evaluate risk factors for in-hospital mortality in adult patients with ascites due to alcoholic cirrhosis.…”

Section: Introductionmentioning

confidence: 99%

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In-hospital mortality risk factors in patients with ascites due to cirrhosis

Vicco¹,

Rodeles²,

Ferini³

et al. 2015

Rev. Assoc. Med. Bras.

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Conflict of interest: noneIntroduction: ascites is one of the most common complications of cirrhosis associated with a high rate of mortality. Although several scores have been developed in order to assess the prognosis of the disease, they were designed for predicting liver transplantation requirements and mortality in the short term, but not while in hospital. The aim of this study was to weigh risk factors for in-hospital mortality in adult patients with ascites due to alcoholic cirrhosis. Material and methods: we performed a cross-sectional study in 180 adult patients with diagnosis of cirrhosis with portal hypertension associated with high alcohol intake. The diagnosis of cirrhosis was made by liver echography and portal hypertension was defined by clinical features plus serum-ascites albumin gradient. Sampled individuals were subjected to complete clinical examination. Child Pugh and the MELD scores were applied in all the patients. Results: nineteen patients died while in-hospital. Mortality was associated with increased levels of serum white blood cell, urea, creatinine, prolonged prothrombin time, aspartate aminotransferase and alanine aminotransferase. We conducted a multiple binary logistic to predict in-hospital mortality which yielded that serum urea, creatinine and prothrombin time made a significant contribution to prediction with an OR 14 (95% CI 12.8 -16.7 p = 0.03), 2 (95% CI 0.5 -3.47, p = 0.04), and 2 (95% CI 1.03 -2.31, p = 0.01) linearly-related. Conclusions: our results suggest that acute renal failure and prolonged prothrombin time are predictors of in-hospital mortality in patients with portal hypertension due to alcoholic cirrhosis.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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In-hospital mortality risk factors in patients with ascites due to cirrhosis

Vicco¹,

Rodeles²,

Ferini³

et al. 2015

Rev. Assoc. Med. Bras.

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“…This treatment was found to be effective in about 50% of patients with type 1 HRS and improves survival (Fagundes and Ginè, 2012). These symptomatic treatments could reduce the risk of developing type 2 HRS (Planas et al, 2006). Another treatment like renal vasodilators (Snowdon et al, 2013) is also an option for managing HRS.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the therapeutic effect of <em>Nigella sativa</em> crude oil and its blend with omega-3 fatty acid-rich oils in a modified hepatorenal syndrome model in rats

et al. 2015

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SUMMARY:In the present study, the hepato and reno-protective effect of Nigella sativa crude oil and its binary blend with omega-3 fatty acid-rich oils (fish and flaxseed oils) was studied in a modified hepatorenal syndrome model (MHRS) in rats. MHRS was induced through feeding a high fructose diet followed by an intraperitoneal injection of galactosamine hydrochloride. Nigella oil and its different blends were given as a daily oral dose to MHRS rats. Two control groups of MHRS and normal healthy rats were run. Different biochemical and nutritional parameters were assessed. The induction of MHRS produced liver and kidney dysfunction, and elevated oxidative stress, an inflammatory biomarker, endothelin 1, and plasma cholesterol. Reduced plasma high density lipoprotein cholesterol, albumin and Ca and elevated urinary N-acetyl-β-D-Glucosaminidase and liver fats were noticed. The administration of Nigella crude oil that originally had 0.2% total omega-3 fatty acids or its blend with fish oil (17.9% omega-3) or flaxseed oil (42.1% omega-3) significantly improved all biochemical parameters of MHRS. There was no significant difference in the biochemical parameters among the different oil treated groups regardless of the omega-3 fatty acid content. This may point out to the potential profound effect of the volatile oil fraction of Nigella crude oil which may compensates for its low omega-3 content. KEYWORDS: Hepatorenal syndrome; Nigella crude oil; Oil blends; Omega-3 fatty acidsRESUMEN: Evaluación del efecto terapéutico del aceite crudo de Nigella sativa y su mezcla con aceites ricos en ácidos grasos omega-3 en un modelo de síndrome hepatorenal modificado en ratas. En el presente estudio, el efecto hepato-y reno-protector de aceites crudos de Nigella sativa y su mezcla binaria con aceites ricos en ácidos grasos omega-3 (pescado y aceites de linaza) fue estudiado en un modelo modificado de síndrome hepatorenal (MHRS) en ratas. MHRS fue inducido a través de la alimentación de una dieta alta en fructosa seguido de la inyección intraperitoneal de clorhidrato de galactosamina. Diferentes aceites fueron suministrados como dosis oral diaria a ratas con MHRS. Se realizaron dos grupos de control de MHRS y ratas sanas normales. Se evaluaron diferentes parámetros bioquímicos y nutricionales. La inducción de la MHRS produce disfunción hepática y renal, elevado estrés oxidativo y biomarcadores inflamatorios, endotelina 1, y colesterol en plasma. Se observó una reducción del colesterol plasmatico de lipoproteínas de alta densidad, albúmina y Ca, elevación en orina de N-acetil-β-D-glucosaminidasa y de la grasa del hígado. La administración de aceite crudo de Nigella que tiene un 0,2% de ácidos grasos omega-3 totales o su mezcla con aceite de pescado (17,9% de omega-3) o aceite de linaza (42,1% de omega-3) mejoró significativamente todos los parámetros bioquímicos de MHRS. No hubo diferencia significativa en los parámetros bioquímicos entre los diferentes grupos tratados con los aceites ensayados independientemente del contenido de áci...

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“…The symptoms of ascites lead to a poor quality of life and prognosis [2]. Recently, the vasopressin V2 receptor antagonist tolvaptan has been used for ascites treatment of cirrhosis in addition to spironolactone ± furosemide [3,4].…”

Section: Introductionmentioning

confidence: 99%

Predictors of the Response to Tolvaptan Therapy and Its Effect on Prognosis in Cirrhotic Patients with Ascites

Kogiso¹,

Yamamoto²,

Kobayashi³

et al. 2017

Ascites - Physiopathology, Treatment, Complications and Prognosis

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Aims: The vasopressin V2 receptor antagonist, tolvaptan, has been reported to be effective in cirrhotic patients with ascites. Here, we evaluated predictors of the response to tolvaptan. Methods: A total of 97 patients with cirrhosis (60 males; median age, 63 years) who had been treated for ascites with oral tolvaptan were enrolled. Tolvaptan efficacy was defined as urine volume increase of ≥500 mL or a urine volume ≥2000 mL/day on the day following treatment. Normalization of the serum sodium (Na) level after 1 week of treatment and the posttreatment survival rate was analyzed. Results: Tolvaptan therapy resulted in effective urination in 67% of patients. A multivariate analysis revealed that the blood urea nitrogen/creatinine (BUN/Cr) ratio and urinary Na/potassium (Na/K) ratio were predictive of the tolvaptan response (p <0.05). The serum Na level was 135 (121-145) mEq/L, and normal levels were recovered in 50.0% of the patients with an initial Na level of <135 mEq/L. The posttreatment survival rate was significantly higher in patients who responded to tolvaptan therapy (p <0.05). Conclusions: The combination of the initial BUN/Cr and urine Na/K ratios and a normalized serum Na level after 1 week was predictive of a favorable outcome to tolvaptan therapy.

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Natural History of Patients Hospitalized for Management of Cirrhotic Ascites

Cited by 347 publications

References 33 publications

In-hospital mortality risk factors in patients with ascites due to cirrhosis

In-hospital mortality risk factors in patients with ascites due to cirrhosis

Evaluation of the therapeutic effect of <em>Nigella sativa</em> crude oil and its blend with omega-3 fatty acid-rich oils in a modified hepatorenal syndrome model in rats

Predictors of the Response to Tolvaptan Therapy and Its Effect on Prognosis in Cirrhotic Patients with Ascites

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