Frequency, pattern and short-term outcome of chronic renal dysfunction in patients with cirrhosis

Silva, Shamila De; Perera, Ruwan; Niriella, Madunil Anuk; Pathmeswaran, A.; Silva, Hithanadura Janaka de

doi:10.1097/meg.0000000000000173

Cited by 4 publications

(4 citation statements)

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“…The prevalence of kidney disease increases gradually with the progression of liver disease, particularly in patients with decompensated hepatic cirrhosis (57). The eGFR significantly decreases with age in patients with hepatic cirrhosis (54,58), with an inverse correlation between baseline eGFR and risk of mortality in patients with hepatic cirrhosis (59). Additionally, renal impairment is a risk factor for mortality in patients with end-stage chronic hepatitis B (60,61).…”

Section: Discussionmentioning

confidence: 99%

Adefovir dipivoxil-induced Fanconi syndrome and its predictive factors: A study of 28 cases

et al. 2016

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Abstract. The aim of the present study was to identify monitoring and prevention measures as well as predictive factors for early detection of renal toxicity associated with long-term administration of adefovir dipivoxil in order to avoid progression to Fanconi syndrome. Clinical data of 28 patients with Fanconi syndrome caused by long-term administration of adefovir dipivoxil for the treatment of chronic hepatitis B virus (HBV) infection were collected pre-and post-administration for analysis. Patients presented with fatigue, progressive systemic pain in multiple bones and joints, as well as difficulty in walking and pathological fractures in a number of severe cases. Laboratory examinations revealed hypophosphatemia, elevated serum cystatin C (Cys-C), elevated serum creatinine (SCr), reduced glomerular filtration rate (GFR), positive urinary protein, erythrocytes and glucose, as well as osteoporosis. In consequence, adefovir dipivoxil administration was stopped, and patients received concentrated divitamins, sodium phosphate syrup and calcitriol. Symptoms and abnormalities in laboratory examinations were significantly improved in all patients after 2-6 months. Therefore, serum phosphate, SCr, routine urine parameters, Cys-C and GFR should be monitored regularly in chronic HBV patients treated with adefovir dipivoxil. The following factors were identified as predictive of kidney damage and Fanconi syndrome: Age ≥40 years, living in rural areas, previous renal toxicity, estimated GFR (eGFR) <90 ml/min/1.73 m 2 , hypertension, diabetes, cirrhosis and duration of adefovir dipivoxil treatment exceeding 24 months. The present results indicate that timely termination of adefovir dipivoxil treatment and replacement with other antiviral agents is critical once renal impairment appears, and that it is necessary to change to other antiviral agents and prolong the interval of administration according to the eGFR level.

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Section: Discussionmentioning

confidence: 99%

Adefovir dipivoxil-induced Fanconi syndrome and its predictive factors: A study of 28 cases

et al. 2016

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“…In this study 15,2% of the patients were diagnosed to have chronic kidney disease even they did not fulfill HRS diagnostic criteria (non-HRS CKD). The overall mortality rates were 52,2% for the patient with HRS and 33,3% for non-HRS CKD for a median follow up period of 9,8 months indicating that short term mortality rate was also high for non-HRS CKD patients (29).…”

Section: Definition Of Chronic Kidney Disease In Cirrhotic Patientsmentioning

confidence: 97%

Renal dysfunctions in cirrhosis

2016

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Kidney dysfunction is a common and potentially life-threating event in patients with cirrhosis, and underlying mechanisms for renal dysfunction are quite variable. Acute kidney injury (AKI) is relatively frequent encountered in approximately 20% of hospitalized patients with cirrhosis. Nevertheless, chronic kidney disease (CKD) occurs in almost 1% of all patients with cirrhosis. In this review various renal problems encountered in cirrhotic patients are discussed and strategies to prevent renal dysfunction are suggested.

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“…without any other organ failure or dysfunction) acute‐on‐chronic liver failure (ACLF) definition criteria (being serum creatinine ≥2 mg/dl the threshold value to define renal failure in the ACLF definition) 23 . CKD in the context of cirrhosis has also been shown to be associated with increased mortality, both in the case of functional [odds ratio (OR) 4.56] and intrinsic (OR 2.19) CKD 24 …”

Section: Introductionmentioning

confidence: 99%

“…23 CKD in the context of cirrhosis has also been shown to be associated with increased mortality, both in the case of functional [odds ratio (OR) 4.56] and intrinsic (OR 2.19) CKD. 24 Consequently, the assessment of kidney function and specifically of its core functional component, the GFR, is essential for several clinical purposes. First, to recognize, even at early stages, correctly diagnose and classify renal impairment, in order to choose the specific treatment according to the type of renal dysfunction.…”

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confidence: 99%

Assessment of glomerular filtration rate in patients with cirrhosis: Available tools and perspectives

Campion

Rizzi

Bonetto

et al. 2022

Liver International

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Renal dysfunction is frequent in cirrhotic patients and is associated with a worse prognosis. 1 Cirrhotic patients share with the general population common aetiologies of kidney dysfunction, including pre-renal, intrinsic and post-renal causes of acute kidney injury (AKI), as well as all the known causes of chronic kidney disease (CKD), such as diabetic or hypertensive nephropathy. 2 Additionally, they may suffer from a specific kind of renal dysfunction, hepatorenal syndrome (HRS). 3,4 Among patients hospitalized for acutely decompensated cirrhosis, about 50% present AKI (definition in Table 1) 5 ; in one-third of them, renal impairment occurs after admission. 6,7 Episodes of AKI can also occur during the follow-up in up to 50% of outpatients with decompensated cirrhosis. 8 As regards CKD (definition in Table 2), 9 this is a highly common comorbidity among patients with liver diseases, and particularly among those with decompensated cirrhosis, in whom the prevalence of CKD stage 3 or higher is reported to range from 20% to 40%. [10][11][12][13]

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Frequency, pattern and short-term outcome of chronic renal dysfunction in patients with cirrhosis

Cited by 4 publications

References 13 publications

Adefovir dipivoxil-induced Fanconi syndrome and its predictive factors: A study of 28 cases

Adefovir dipivoxil-induced Fanconi syndrome and its predictive factors: A study of 28 cases

Renal dysfunctions in cirrhosis

Assessment of glomerular filtration rate in patients with cirrhosis: Available tools and perspectives

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