Renal Dysfunction in Chronic Liver Disease

Slack, Andy; Yeoman, Andrew D.; Wendon, Julia

doi:10.1007/978-1-4419-5562-3_33

Cited by 7 publications

(10 citation statements)

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“…Generally, serum TC, TAG and LDL-C concentrations of Groups (5-12) were higher than that of Group 4, and in turn, those of Group 4 was higher than those of Group 1 and Group 2; p < 0.05. An overview of Table 2 showed that atherogenic indices of Group 1 and Group 2 were below the critical values, whereas those of Groups (3)(4)(5)(6)(7)(8)(9)(10)(11)(12) were within the following ranges: TAG/HDL-C ratio (3.59 ± 0.03 -6.76 ± 0.06), TC/HDL-C ratio (3.72 ± 0.02 -6.94 ± 0.05) and LDL-C/HDL-C ratio (2.00 ± 0.01 -4.59 ± 0.02). The histopathological features of hepatic tissue sections of the experimental rat groups are presented in Figure 6.…”

Section: Discussionmentioning

confidence: 99%

“…4 Biochemical investigations using hepatic and renal functional indices, the so-called liver function test (LFT) and kidney function test (KFT), coupled with histopathological studies have revealed that dysfunctional and morphological damage hepatic tissues predispose animal models to developing acute renal failure when exposed, in acute way, to chemical toxicants. 5,6,7,8,9 Carbon tetrachloride (CCl 4 ) is a chemical agent noted to be toxic to hepatorenal tissues in experimental animals and human subjects. 5,6,8,10,11,12,13 Reports showed that CCl 4 toxicity is elicited by microsomal CYP2E1-induced formation of reactive trichloromethyl (CCl 3…”

Section: Introductionmentioning

confidence: 99%

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Functional Assessments and Histopathology of Hepatorenal Tissues of Wistar Rats Infused with Carbon Tetrachloride and Treated with Raw and Hydrothermal Processed Herbs

Ojiako¹,

Chikezie²,

Ukairo³

et al. 2017

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Background and Aim: Herbal remedies offer another strategy for alleviation of co-existing liver and kidney pathologic conditions. Objective: The present study ascertained the functional integrity of hepatic and renal tissues, concurrently with blood lipid patterns, of Wistar rats infused with CCl 4 and treated with raw and hydrothermal processed herbs, namely, Monodora myristica, Chromolaena odorata, Buccholzia coriacea and Sphenostylis stenocarpa. Materials and Methods: Measurement of phytochemical contents of the herbs was according to standard methods. The rats were randomly designated on the basis of diets and treatments received for 28 consecutive days. Fibrosis was induced in the Wistar rats by single dose intra-peritoneal injection of CCl 4 for 2 consecutive days. Liver and kidney function tests and serum lipid profile were measured using spectrophotometric methods. Renal and hepatic tissues were subjected to histopathological examinations. Results: The concentrations of alkaloids in the four herbal extracts were within the range of 4.83 ± 0.03 -31.33 ± 0.29 mg/100 g sample, whereas the concentrations of saponins varied within a relatively narrow range: 0.33 ± 0.09 -4.33 ± 0.02 mg/100 g dry sample; p > 0.05. The activity ratios of AST to ALT of the rat groups were generally less than 1.0 unit. Atherogenic indices of fibrotic rats were within the following ranges: TAG/HDL-C ratio (3.59 ± 0.03 -6.76 ± 0.06), TC/HDL-C ratio (3.72 ± 0.02 -6.94 ± 0.05) and LDL-C/HDL-C ratio (2.00 ± 0.01 -4.59 ± 0.02). Conclusion: Losses in phytochemical contents following hydrothermal processing of the herbs did not substantially affect their overall therapeutic scores against morphological and functional impairments of hepatic and renal tissues following CCl 4 intoxication of the rats.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Functional Assessments and Histopathology of Hepatorenal Tissues of Wistar Rats Infused with Carbon Tetrachloride and Treated with Raw and Hydrothermal Processed Herbs

Ojiako¹,

Chikezie²,

Ukairo³

et al. 2017

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“…21 Impaired renal function with advanced liver disease and hemorrhagic risk is a multifactorial relationship. Chronic hepatitis is associated with glomerulonephritis, albuminuria, and progression of existing renal disease, as well as places patients at risk for acute kidney injury because of physiological changes that affect the circulation and kidney perfusion, 22 and hepatorenal syndrome is a complication of advanced liver disease. Furthermore, the elevation of creatinine above the normal range may suggest advanced liver disease; normal renal function may be an underestimate in patients with liver disease because they tend to have baseline creatinine lower than the general population because of volume distribution, accumulation of extracellular fluid, malnutrition, edema, lower lean body mass, and ascites.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the elevation of creatinine above the normal range may suggest advanced liver disease; normal renal function may be an underestimate in patients with liver disease because they tend to have baseline creatinine lower than the general population because of volume distribution, accumulation of extracellular fluid, malnutrition, edema, lower lean body mass, and ascites. 22 Colinearity may explain why the other variables added little to the model, although individually each had some effect on both TTR and hemorrhagic events. Low levels of cholesterol are likely associated closely with albumin because both are associated with diminished synthetic function of the liver.…”

Section: Discussionmentioning

confidence: 99%

Stratifying the Risks of Oral Anticoagulation in Patients With Liver Disease

Efird

Mishkin

Berlowitz

et al. 2014

Circ: Cardiovascular Quality and Outcomes

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Background— Chronic liver disease presents a relative contraindication to warfarin therapy, but some patients with liver disease nevertheless require long-term anticoagulation. The goal is to identify which patients with liver disease might safely receive warfarin. Methods and Results— Among 102 134 patients who received warfarin from the Veterans Affairs from 2007 to 2008, International Classification of Diseases -Ninth Revision codes identified 1763 patients with chronic liver disease. Specific diagnoses and laboratory values (albumin, aspartate aminotransferase, alanine aminotransferase, creatinine, and cholesterol) were examined to identify risk of adverse outcomes, while controlling for available bleeding risk factors. Outcomes included percent time in therapeutic range, a measure of anticoagulation control, and major hemorrhagic events, by International Classification of Diseases -Ninth Revision codes. Patients with liver disease had lower mean time in therapeutic range (53.5%) when compared with patients without (61.7%; P <0.001) and more hemorrhages (hazard ratio, 2.02; P <0.001). Among patients with liver disease, serum albumin and creatinine levels were the strongest predictors of both outcomes. We created a 4-point score system: patients received 1 point each for albumin (2.5–3.49 g/dL) or creatinine (1.01–1.99 mg/dL), and 2 points each for albumin (<2.5 g/dL) or creatinine (≥2 mg/dL). This score predicted both anticoagulation control and hemorrhage. When compared with patients without liver disease, those with a score of zero had modestly lower time in therapeutic range (56.7%) and no increase in hemorrhages (hazard ratio, 1.16; P =0.59), whereas those with the worst score (4) had poor control (29.4%) and high hazard of hemorrhage (hazard ratio, 8.53; P <0.001). Conclusions— Patients with liver disease receiving warfarin have poorer anticoagulation control and more hemorrhages. A simple 4-point scoring system using albumin and creatinine identifies those at risk for poor outcomes.

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“…Moreover, Slack, Yeoman, and Wendon (2010) reported that 47% of liver transplant patients develop either acute kidney injury (20%) or chronic kidney disease (27%), and patients from both of these categories could be suitable for SLK transplants. 29 For checking tissue-type compatibility, we generate a statistic known as panel reactive antibody (PRA) for each patient.…”

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confidence: 99%

Dual-Donor Organ Exchange

Ergin¹,

Sönmez²,

Ünver³

2017

Econometrica

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APPENDIX B: DYNAMIC SIMULATIONSIN THE DYNAMIC SIMULATIONS, PATIENTS AND THEIR DONORS ARRIVE over time and remain in the population until they are matched through exchange. We run statically optimal exchange algorithms once in each period. 25 In each simulation, we generate S = 500 such populations and report the averages and sample standard errors of the simulation statistics. B.1. Dynamic Simulations for Lung ExchangeIn the dynamic lung-exchange simulations, we consider 200 triples arriving over 20 periods at a uniform rate of 10 triples per period. This time horizon roughly corresponds to more than 1 year of Japanese patient arrival, when exchanges are run once about every 3 weeks. We only consider the 2-way and 2&3-way exchange regimes.Based on the 2&3-way exchange simulation results reported in Table V, we can increase the number of living-donor transplants by 190%, thus nearly tripling them. This increase corresponds to 24% of all triples in the population. Even the logistically simpler 2-way exchange technology has a potential to increase the number of living-donor transplants by 125%. B.2. Dynamic Simulations for Dual-Graft Liver ExchangeFor dual-graft liver exchange, we consider 500 triples arriving over 20 periods at a uniform rate of 25 triples per period. In each period, we follow the same four-step transplantation scenario we used for the static simulations. The unmatched triples remain in the patient population waiting for the next period. 26Haluk Ergin: hie@berkeley.edu Tayfun Sönmez: sonmezt@bc.edu M. Utku Ünver: unver@bc.edu 25 Moreover, among the optimal matchings, we choose a random one rather than using a priority rule to choose whom to match now and whom to leave to future runs. The number of patients who can be matched dynamically can be further improved using dynamic optimization. For example, see Ünver (2010) for such an approach for kidney exchanges. 26 Roughly, a dynamic simulation corresponds to 3 5 months in real time and the exchange is run once every 5-6 days. This is a very crude mapping that relies on our specific patient and paired donor generation

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Renal Dysfunction in Chronic Liver Disease

Cited by 7 publications

References 50 publications

Functional Assessments and Histopathology of Hepatorenal Tissues of Wistar Rats Infused with Carbon Tetrachloride and Treated with Raw and Hydrothermal Processed Herbs

Functional Assessments and Histopathology of Hepatorenal Tissues of Wistar Rats Infused with Carbon Tetrachloride and Treated with Raw and Hydrothermal Processed Herbs

Stratifying the Risks of Oral Anticoagulation in Patients With Liver Disease

Dual-Donor Organ Exchange

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