Overestimated renal function in patients with liver cirrhosis predicts poor prognosis

Yoshida, Shuhei; Suda, Goki; Ohara, Masatsugu; Kimura, Megumi; Yang, Zijian; Maehara, Osamu; Fu, Qingjie; Hosoda, Shunichi; Kubo, Akinori; Yamada, Ryoichi; Kitagataya, Takashi; Suzuki, Kazuharu; Kawagishi, Naoki; Nakai, Masato; Sho, Takuya; Natsuizaka, Mitsuteru; Morikawa, Kenichi; Ogawa, Koji; Ohnishi, Shunsuke; Sakamoto, Naoya

doi:10.1111/hepr.13765

Cited by 7 publications

(7 citation statements)

References 28 publications

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“…This could be due to appetite loss, causing deterioration of the liver functional reserve, which in turn hindered salvage therapy after lenvatinib treatment. Additionally, elevated FGF21 [ 35 ] and decreased food intake could cause a loss of muscle mass, as sarcopenia in patients with chronic liver disease [ 36 , 37 , 38 ] is an independent factor that contributes to poor prognosis. It might also affect the poor patient prognosis observed in this study.…”

Section: Discussionmentioning

confidence: 99%

Potential Correlation between Changes in Serum FGF21 Levels and Lenvatinib-Induced Appetite Loss in Patients with Unresectable Hepatocellular Carcinoma

Kohya

Suda

Ohara

et al. 2023

Cancers

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Lenvatinib, used for unresectable hepatocellular carcinoma (HCC), causes appetite loss, but the underlying mechanisms, clinical impact, and predictive factors have been unclear. The endocrine factor FGF21 modulates appetite and is involved in cachexia. We evaluated the association between FGF21 level changes during lenvatinib treatment for unresectable HCC and appetite loss. Sixty-three eligible unresectable HCC patients who started lenvatinib treatment between 2018 and 2021 were included. We analyzed FGF21 levels at baseline; 1, 2, and 4 weeks after lenvatinib initiation, and before the onset of appetite loss. Grade ≥ 2 lenvatinib-induced appetite loss led to liver functional reserve deterioration at disease progression and a poor prognosis. Baseline characteristics and serum FGF21 levels were similar between patients with and without appetite loss. However, the serum FGF21 change rate increased significantly at 4 weeks post-lenvatinib initiation in patients with grade ≥ 2 appetite loss, as compared to those without appetite loss. Similar significant increases in the serum FGF21 level change rate were observed prior to grade ≥ 2 appetite loss onset. This suggests that changes in FGF21 levels can be used to predict patients with a greater risk of marked appetite loss and provides insights into the mechanisms underlying lenvatinib-induced appetite loss in patients with HCC.

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Section: Discussionmentioning

confidence: 99%

Potential Correlation between Changes in Serum FGF21 Levels and Lenvatinib-Induced Appetite Loss in Patients with Unresectable Hepatocellular Carcinoma

Kohya

Suda

Ohara

et al. 2023

Cancers

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“…Laboratory data were evaluated, and imaging tests were performed using echocardiography, CT, or MRI to detect HCC occurrence and recurrence. In this study, referring to the previous studies [ 22 , 23 , 24 ], liver cirrhosis was diagnosed by laboratory findings, liver histology, radiologic findings, and/or liver stiffness data using FibroScan (Echosens, Paris, France).…”

Section: Methodsmentioning

confidence: 99%

Serum Angiopoietin-2 Predicts the Occurrence and Recurrence of Hepatocellular Carcinoma after Direct-Acting Antiviral Therapy for Hepatitis C

Kawagishi

Suda²,

Yamamoto³

et al. 2023

Viruses

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Progressive liver fibrosis after anti-HCV treatment is a risk factor for HCC. Angiopoietin-2 (Ang2) is associated with non-regression of liver fibrosis after direct-acting antiviral (DAA). This study evaluated the predictive value of serum Ang2 levels for HCC occurrence or recurrence after DAA administration. In this retrospective study, 310 HCV-infected patients treated with DAAs in 2014–2020 were screened and evaluated for HCC occurrence or recurrence every three–six months. Multivariate Cox regression analysis revealed that age ≥ 75 years (HR: 2.92, 95% CI: 1.34–6.33; p = 0.007) and baseline Ang2 level ≥ 464 pg/mL (HR: 2.75, 95% CI: 1.18–6.37; p = 0.019) were significantly associated with HCC occurrence after DAA therapy. A high or low risk of HCC after DAA therapy could be distinguished by the combination of age and baseline Ang2 level. The cumulative incidences of de-novo HCC at two and four years were 0.8% and 3.8% in the low-risk group and 22.6% and 27.1% in the high-risk group, respectively. Baseline Ang2 level ≥ 402 pg/mL was significantly associated with HCC recurrence in patients who achieved sustained virological response with DAAs (HR: 3.68). In conclusion, serum Ang2 levels can predict HCC occurrence and recurrence after successful HCV eradication by DAAs.

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“…Clinical information was collected from the enrolled patients, which included laboratory data, history or presence of HCC, treatments for HBV infection, HBV status, coinfection with HIV or HCV, and FIB‐4 index. We diagnosed LC using liver biopsy, Fibroscan data; Echosens, radiological findings, and laboratory data as previously described 11,12 …”

Section: Methodsmentioning

confidence: 99%

“…We diagnosed LC using liver biopsy, Fibroscan data; Echosens, radiological findings, and laboratory data as previously described. 11,12 The ethics committee of Hokkaido University Hospital confirmed that the study protocol (IRB 021-0164) conformed to the ethical guidelines of the Declaration of Helsinki. Patients who provided written informed consent or did not decline to participate were included in the study.…”

Section: Included Patients and Study Designmentioning

confidence: 96%

Recent prevalence and characteristics of patients with hepatitis delta virus in Hokkaido, Japan

Sasaki

Suda

Ohara

et al. 2023

Hepatology Research

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AimAlthough hepatitis delta virus (HDV) coinfection with hepatitis B virus (HBV) is a global health concern, the global prevalence of HDV infections remains unknown due to insufficient data in many countries. In Japan, HDV prevalence has not been updated for over 20 years. We aimed to investigate the recent prevalence of HDV infections in Japan.MethodsWe screened 1264 consecutive patients with HBV infection at Hokkaido University Hospital between 2006 and 2022. Patients' serums were preserved and subsequently tested for HDV antibody (immunoglobulin‐G). Available clinical information was collected and analyzed. We compared the changes in liver fibrosis using the Fibrosis‐4 (FIB‐4) index between propensity‐matched patients with and without the evidence of anti‐HDV antibodies and corrected for baseline FIB‐4 index, nucleoside/nucleotide analog treatment, alcohol intake, sex, HIV coinfection, liver cirrhosis, and age.ResultsAfter excluding patients without properly stored serums and those lacking appropriate clinical information, 601 patients with HBV were included. Of these, 1.7% of patients had detectable anti‐HDV antibodies. Patients with anti‐HDV antibody serum positivity had a significantly higher prevalence of liver cirrhosis, significantly lower prothrombin time, and a higher prevalence of HIV coinfection than those who demonstrated serum anti‐HDV antibody negativity. A propensity‐matched longitudinal analysis revealed that liver fibrosis (FIB‐4 index) progressed more rapidly in patients with positive results for anti‐HDV antibody tests.ConclusionsThe recent prevalence of HDV infections in Japanese patients with HBV was 1.7% (10/601). These patients experienced rapid liver fibrosis progression, highlighting the importance of routine HDV testing.

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Overestimated renal function in patients with liver cirrhosis predicts poor prognosis

Cited by 7 publications

References 28 publications

Potential Correlation between Changes in Serum FGF21 Levels and Lenvatinib-Induced Appetite Loss in Patients with Unresectable Hepatocellular Carcinoma

Potential Correlation between Changes in Serum FGF21 Levels and Lenvatinib-Induced Appetite Loss in Patients with Unresectable Hepatocellular Carcinoma

Serum Angiopoietin-2 Predicts the Occurrence and Recurrence of Hepatocellular Carcinoma after Direct-Acting Antiviral Therapy for Hepatitis C

Recent prevalence and characteristics of patients with hepatitis delta virus in Hokkaido, Japan

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