Renal Failure in Patients with Cirrhosis

Mackelaite, Lina; Alsauskas, Zygimantas; Ranganna, Karthik

doi:10.1016/j.mcna.2009.03.003

Cited by 38 publications

(26 citation statements)

References 77 publications

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“…According to one study, patients with MELD scores lower than 20 had a median survival time of 11 months. 18 We observed a median survival time of 50 months for the cirrhosis group. In fact, all of those patients were alive over a 12-month postoperative period.…”

Section: Discussionmentioning

confidence: 69%

“…5 The median survival time of cirrhotics with a MELD score of 20 or less is 11 months. 18 The National Kidney Foundation and the AASLD consider cirrhosis a relative contraindication to KTA. It has been suggested that HCV-infected patients with cirrhosis but clinically compensated liver disease be considered for kidney transplantation only in an investigational setting.…”

Section: Discussionmentioning

confidence: 99%

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Equal 3-Year Outcomes for Kidney Transplantation Alone in HCV-Positive Patients With Cirrhosis

Parsikia

Campos

Khanmoradi

et al. 2015

International Surgery

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Kidney transplantation alone in clinically compensated patients with cirrhosis is not well documented. Current guidelines list cirrhosis as a contraindication for kidney transplantation alone. This is an Institutional Review Board-approved retrospective study. We report our experience with a retrospective comparison between transplants in hepatitis C virus-positive (HCV þ ) patients without cirrhosis and HCV þ patients with cirrhosis. All of the patients were followed for at least a full 3-year period. All of the deaths and graft losses were recorded and analyzed using Kaplan-Meier methodology. One-and three-year cumulative patient survival rates for noncirrhotic patients were 91% and 82%, respectively. For cirrhotic patients, one-and three-year cumulative patient survival rates were 100% and 83%, respectively (P ¼ NS). One-and three-year cumulative graft survival rates censored for death were 94% and 81%, and 95% and 82% for the noncirrhosis and cirrhosis groups, respectively (P ¼ NS). Comparable patient and allograft survival rates were observed when standard kidney allograft recipients were analyzed separately. This study is the longest follow-up document in the literature showing that HCV þ clinically ompensated patients with cirrhosis may undergo kidney transplantation alone as a safe and viable practice.

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Equal 3-Year Outcomes for Kidney Transplantation Alone in HCV-Positive Patients With Cirrhosis

Parsikia

Campos

Khanmoradi

et al. 2015

International Surgery

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“…IgM deposits are not expected in Berger's nephropathy (also known as IgG-IgA nephropathy) 36 . Glomerular deposition of IgA is also common in patients with liver cirrhosis and it has been explained by impairment in the depuration of immunoglobulins by Kupffer cells 37 . More recently, it has been shown that the IgA deposited in Berger's nephropathy is structurally abnormal (sub-galactosylated molecules) and that it is possible to investigate the structure of its molecule.…”

Section: Discussionmentioning

confidence: 99%

Glomerulonephritis in schistosomiasis mansoni: a time to reappraise

Rodrigues

Otoni

Voieta

et al. 2010

Rev. Soc. Bras. Med. Trop.

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Introduction:The current prevalence of glomerulonephritis in patients with hepatosplenic schistosomiasis mansoni in Brazil was evaluated. Methods: Sixty three patients (mean age 45.5±11 years) attending the outpatient infectious disease clinic of a University Hospital in Belo Horizonte, Brazil, from 2007 to 2009, were consecutively examined and enrolled in the present investigation. Diagnosis of hepatosplenic schistosomiasis was based on epidemiological, clinical and parasitological data and imaging techniques. Eight patients, who presented >30mg/day albuminuria, were submitted to percutaneous ultrasound guided renal biopsy. Kidney tissue fragments were examined under light, direct immunofluorescence and electron microscopy. Results: All patients showed mesangial enlargement. In five, mesangial hypercellularity was observed and four presented duplication of the glomerular basement membrane. Areas of glomerular sclerosis were diagnosed in four. Deposits of immunoglobulin M and C3 were present in six samples; deposits of IgG in four, IgA in three and C1q in two samples. In all patients, immunoglobulin A was reported in the lumen of renal tubules. Deposits of kappa and lambda were observed in six samples. Electron microscopy revealed dense deposits in the glomerular tissue of three patients. Arterial hypertension, small esophageal varices, slight increases in serum creatinine and decreases in serum albumin were associated with glomerular disease. Conclusions: Renal disease associated with hepatosplenic schistosomiasis was verified in 12.7% of patients and type I membranoproliferative glomerulonephritis was observed in 50% of them. Schistosomal glomerulopathy still is an important problem in patients with hepatosplenic schistosomiasis in Brazil.

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“…The combination of liver disease and renal failure portends a poor prognosis and is associated with increased mortality. 22 HRS is the most common fatal complication of cirrhosis. 23 HRS is defined as acute or subacute renal failure in the presence of advanced liver disease and structurally normal kidneys.…”

Section: Hepatorenal Syndromementioning

confidence: 99%