Prevalence and short‐term outcome of acute kidney injury in patients with acute‐on‐chronic liver failure: A meta‐analysis

Jiang, Weiyun; Hu, Yechao; Sun, Yan; Shen, Yueli; Xun, Yunhao

doi:10.1111/jvh.13287

Cited by 13 publications

(8 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This difference in data from this work in relation to other studies could be related to the use of other vasopressors such as midodride/octreotide and the variability of the studied patients at the demographic level [42]. In a recent meta-analysis, Jiang et al [43]. collected 9 eligible articles from observational studies of HRS patients, determining an estimated average response to vasopressor of 32%, which is comparable with the results of our study.…”

Section: Plos Onesupporting

confidence: 74%

Prevalence and short-term outcome of hepatorenal syndrome: A 9-year experience in a high-complexity hospital in Colombia

et al. 2020

View full text Add to dashboard Cite

Background & aims Hepatorenal syndrome is a rare entity that is part of the complications of liver cirrhosis in its more severe stages. Without treatment, its mortality rate increases significantly. Terlipressin is considered to be the therapy of choice until the need of a liver transplant. The aim is to determine its prevalence, define patients' characteristics, triggers and 90-day survival, according to the type of managements established. Method This was a retrospective cohort study conducted in Colombia. It included patients with cirrhosis and acute kidney injury who met hepatorenal syndrome criteria, reaching 28 patients from 2007 to 2015. Groups were categorized according the type of hepatorenal syndrome and treatment. Demographic and trigger factors were evaluated to characterize the population. Treatment outcomes with terlipressin vs norepinephrine were analyzed up to a 90-day survival, using log Rank test. Continuous variables needed Student's T and Mann Whitney's U tests and categorical variables, Chi2 test. A value of p <0.05 and a power of 85% was considered. The data was analyzed in the SPSS version 23 software. Results 117 patients with cirrhosis developed renal injury; of these 23.9% were diagnosed with Hepatorenal Syndrome (67.8% type1; 32.1% type2). The presence of ascites was 100% in HRS2 and 84% in HRS1 (p = 0.296). The main trigger in both types was paracentesis greater than 5 liters in the last 4 weeks (39.3%). In total, 35% of the patients received renal replacement therapy and 14% underwent a hepatic transplant. Type 1 was more frequent (63% received terlipressin; 21% norepinephrine). The total complete response was 36%

show abstract

Section: Plos Onesupporting

confidence: 74%

Prevalence and short-term outcome of hepatorenal syndrome: A 9-year experience in a high-complexity hospital in Colombia

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Meta-analysis had reported HRS reverse rate as 42.0% in response to terlipressin treatment [32] . In our study, reverse rate was 35.39% with terlipressin plus albumin, better than albumin alone for HRS-AKI in ACLF, consistent with previous studies [18,30] and meta-analysis [33] .…”

Section: Discussionsupporting

confidence: 92%

Terlipressin for Hepatorenal Syndrome-Acute Kidney Injury in Acute-On-Chronic Liver Failure: A Single-Center Retrospective Cohort Study

liu

Meng

et al. 2021

Preprint

View full text Add to dashboard Cite

Objectives: Patients with hepatorenal syndrome-acute kidney injury (HRS-AKI) based on acute-on-chronic liver failure (ACLF) have a high rate of mortality. Terlipressin combined with albumin is the first line therapy for HRS-AKI in cirrhosis, however, whether it is more effective than albumin alone in ACLF is unclear. We aimed to analyze therapeutic effects of terlipressin in these patients. Methods: A retrospective study was conducted on patients with HRS-AKI based on ACLF at Beijing You’an Hospital between October 2010 and October 2019. The primary endpoint was a reversal rate of HRS-AKI, which was defined as serum creatinine (sCr) reduced to within 0.3 mg/dL of baseline. The secondary endpoints included a reversal rate of HRS in patients with sCr<1.5mg/dL and 28-day survival. Results: 221 of 755 patients meet inclusion criteria. 113 cases were treated with terlipressin plus albumin (TA group), whereas 108 cases with albumin alone (AA group). The reversal rate of HRS-AKI in TA group was higher compared to in AA group (35.39% vs 23.15%, P = 0.046). Additionally, reversal time in TA group was 8.18 ± 4.39 days, compared to 11.29 ± 3.67 days in AA group ( P = 0.005). In patients with sCr < 1.5mg/dL, reversal rate of HRS-AKI in TA group was 41.46% (17/47) compared to 19.61% (10/51) in AA group (P = 0.067). Furthermore, reversal time in TA group was 8.12±5.75 days, compared to 9.40±2.67 days in AA group (P=0.117). Notably, 28-day overall survival and transplantation-free survival in TA group was better than AA group (P < 0.001).Conclusions: Terlipressin combined albumin was effective for HRS-AKI in ACLF. Combination therapy tends to be more beneficial for patients with sCr level <1.5 mg/dL.

show abstract

“…Nevertheless, the buildup of toxic substances is not only due to the deterioration of hepatic functions, but may also be due to renal impairment, something that is often seen in multiple system organ failure and also in liver failure. Acute kidney injury develops in about 60% of the critically ill [ 25 ] and in 40% in liver failure [ 26 , 27 , 28 ]. Furthermore, the accumulation of bilirubin in the distal nephron segments and proximal tubules in the kidneys contributes to kidney injury often seen in liver failure and the critically ill [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Hemoadsorption in ‘Liver Indication’—Analysis of 109 Patients’ Data from the CytoSorb International Registry

Ocskay

Tomescu

Faltlhauser

et al. 2021

JCM

View full text Add to dashboard Cite

Background: Our aim is to report the results of the ‘liver indication’ subset of patients in the CytoSorb International Registry. Methods: Structured data were recorded. Treatment characteristics and changes from T1 (start of hemoadsorption) to T2 (termination) were evaluated with a special focus on bilirubin, C-reactive protein, procalcitonin, interleukin-6, platelet levels, SOFA scores, mortality, and subjective assessment by the attending physicians. Results: Until January 2021, from the total 1434 patients, 109 (age: 49.2 ± 17.1 years, 57.8% males) received treatment for hyperbilirubinemia. APACHE II-predicted mortality was 49.6 ± 26.8%. In the study, 91% of patients were alive at the termination of hemoadsorption and improvement was observed by the physicians in 75 cases. Overall, 65 (59.6%) patients died in the hospital, and 60 (55.0%) died in the ICU. Patients received a median of two treatments for a median of 43 h (interquartile range: 24–72 h) in total. Serum bilirubin levels reduced significantly to −4.6 (95% CI: −6.329 to −2.8) mg/dL. Thrombocytopenia was reported in four patients as an adverse event. Conclusions: We report the largest case series on hemoadsorption for ‘liver indication’ from the CytoSorb International Registry. The finding of significant bilirubin removal observed in our study could have substantial impact in designing and executing further studies on the effects of hemoadsorption in liver dysfunction, which are certainly warranted.

show abstract

Prevalence and short‐term outcome of acute kidney injury in patients with acute‐on‐chronic liver failure: A meta‐analysis

Cited by 13 publications

References 33 publications

Prevalence and short-term outcome of hepatorenal syndrome: A 9-year experience in a high-complexity hospital in Colombia

Prevalence and short-term outcome of hepatorenal syndrome: A 9-year experience in a high-complexity hospital in Colombia

Terlipressin for Hepatorenal Syndrome-Acute Kidney Injury in Acute-On-Chronic Liver Failure: A Single-Center Retrospective Cohort Study

Hemoadsorption in ‘Liver Indication’—Analysis of 109 Patients’ Data from the CytoSorb International Registry

Contact Info

Product

Resources

About