Continuous renal replacement therapy in critically ill patients with acute on chronic liver failure and acute kidney injury: A retrospective cohort study

Saraiva, Ivan Euclides Borges; Ortiz-Soriano, Victor; Mei, Xiaonan; Gianella, Fabiola; Woc, Winnie Sheu; Zamudio, Rodrigo; Kelly, Andrew; Gupta, Meera; Grigorian, Alla; Neyra, Javier A.

doi:10.5414/cn109983

Cited by 20 publications

(13 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[ 34 ] reported that 82 of 120 (68.3%) patients with ACLF and HRS-AKI required RRT at a median of 4 days. Yet, patients with ACLF and AKI requiring CRRT exhibited a poor survival, even with the provision of extracorporeal support therapy [ 162 ]. Such intervention appears to only prolong hospital stay [ 163 ].…”

Section: Treatment Of Hrs-aki With Aclfmentioning

confidence: 99%

Hepatorenal syndrome in acute-on-chronic liver failure with acute kidney injury: more questions requiring discussion

Liu

Meng

et al. 2021

Gastroenterology Report

View full text Add to dashboard Cite

In cirrhosis with ascites, hepatorenal syndrome (HRS) is a specific prerenal dysfunction unresponsive to fluid volume expansion. Acute-on-chronic liver failure (ACLF) comprises a group of clinical syndromes with multiple organ failure and early high mortality. There are differences in the characterization of ACLF between the Eastern and Western medical communities. Patients with ACLF and acute kidney injury (AKI) have more structural injuries, contributing to confusion in diagnosing HRS-AKI. In this review, we discuss progress in the pathogenesis, diagnosis, and management of HRS-AKI, especially in patients with ACLF. Controversy regarding HRS-AKI in ACLF and acute liver failure, hepatic carcinoma, shock, sepsis, and chronic kidney disease is also discussed. Research on the treatment of HRS-AKI with ACLF needs to be more actively pursued to improve disease prognosis.

show abstract

Section: Treatment Of Hrs-aki With Aclfmentioning

confidence: 99%

Hepatorenal syndrome in acute-on-chronic liver failure with acute kidney injury: more questions requiring discussion

Liu

Meng

et al. 2021

Gastroenterology Report

View full text Add to dashboard Cite

show abstract

“…In its absence, prolonged intermittent renal replacement therapy holds for those with cirrhosis and advanced liver failure. 99 , 100 At present, for patients with COVID-19 and severe or critical illness, empiric broad-spectrum antimicrobial therapy in the absence of another indication is not recommended. However, in the cirrhotic population, especially among those with decompensation such as variceal bleeding or those with ACLF, early empirical antibiotics may be considered since the patients are at high risk of developing hospital-acquired infections and secondary bacteremia.…”

Section: Supportive Treatment For Severe or Critically Ill Covid-19 Patients With Cirrhosismentioning

confidence: 99%

Critically Ill COVID-19 Patient with Chronic Liver Disease - Insights into a Comprehensive Liver Intensive Care

Philips¹,

Kakkar²,

Joseph³

et al. 2021

Journal of Clinical and Translational Hepatology

View full text Add to dashboard Cite

This eleventh review of global reporting of ADRs for drugs used to treat COVID-19 is as before mainly descriptive in nature. It includes reviews for the drugs that were initially included in WHO Solidarity trial to find an effective COVID-19 treatment and other drugs used for a COVID-19 indication where the number of reports in VigiBase exceeds 100. Regarding remdesivir, a major increase in reports was seen in this review. Notable numbers of reports for several non-labelled ADR terms have been shared within the system, described in the remdesivir section of the document. Concerning the other drugs reviewed, ADR-patterns are consistent with those described in earlier reports and mostly within the labelling for the respective drugs. Reports have been shared from all WHO regions, with the largest number now originating in the WHO region of the Americas with 45% of the shared reports (Table 2). WHO has announced the discontinuation of the hydroxychloroquine (HCQ) and lopinavir;ritonavir arms of the Solidarity trial as per the recommendation from the international steering committee 1 . The decision applies only to the conduct of the Solidarity trial in hospitalized patients and does not affect the possible evaluation in other studies of hydroxychloroquine or lopinavir;ritonavir in nonhospitalized patients or as pre-or post-exposure prophylaxis for COVID-19.

show abstract

“…Renal replacement is the only reasonable approach when renal damage supervenes. RRT is recommended in case of worsening AKI, worsening fluid overload despite diuretic therapy or worsening acid-base status [52]. The role of dialysis however, is still under evaluation and in clinical practice; it is mostly reserved to patients candidate for OLT [50,53].…”

Section: Treatment Of Renal Failurementioning

confidence: 99%

Acute on Chronic Liver Failure: Role of the Bacterial Infections

Borzio¹,

Dionigi²

2021

Liver Pathology

View full text Add to dashboard Cite

Acute-on-chronic liver failure (ACLF) refers to a syndrome characterized by acute deterioration of liver function of a pre-existing chronic liver disease with increased short-term mortality at 3 months due to multiorgan failure. Definition of ACLF has been refined, but differences between western and eastern areas still exist. Diagnosis of ACLF as recommended by the EASL-CLIF consortium is based on the assessment of organ dysfunction. The pathogenesis of this syndrome is attributable to an exaggerated host response to inflammation, responsible for the severe haemodynamic derangement leading to multiorgan failure. ACLF is triggered by precipitating events like acute hepatitis either viral, drug-induced, toxic, or alcoholic, variceal bleeding and sepsis. Bacterial infection is currently considered the most frequent trigger of ACLF in Western countries. Cirrhotic patients, particularly if decompensated are prone to develop bacterial infection because loss of integrity of the intestinal mucosal barrier and translocation of pathogenassociated molecular patterns (PAMPs). Bacterial translocation may develop into overt infection at different sites, along with sepsis and septic shock that may lead to ACLF. Epidemiology of bacterial infection in cirrhosis has been changing and this accounts for new antibiotic regimens as empirical therapy in critically ill cirrhotic patients with bacterial infection. In this chapter, we will discuss on definition, pathogenesis, clinical aspects and therapy of bacterial infection-related ACLF.

show abstract

Continuous renal replacement therapy in critically ill patients with acute on chronic liver failure and acute kidney injury: A retrospective cohort study

Cited by 20 publications

References 0 publications

Hepatorenal syndrome in acute-on-chronic liver failure with acute kidney injury: more questions requiring discussion

Hepatorenal syndrome in acute-on-chronic liver failure with acute kidney injury: more questions requiring discussion

Critically Ill COVID-19 Patient with Chronic Liver Disease - Insights into a Comprehensive Liver Intensive Care

Acute on Chronic Liver Failure: Role of the Bacterial Infections

Contact Info

Product

Resources

About