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. 2021 Nov;41(11):2729-2732.
doi: 10.1111/liv.15069. Epub 2021 Oct 5.

Sequential changes in urinary biomarker levels in patients with cirrhosis and severe hepatorenal syndrome

Cristina Solé  1   2 , Ann T Ma  1   2 , Elsa Solà  1   2   3 , Marta Carol  2   3   4 , Núria Fabrellas  2   3   4 , Adrià Juanola  1   2 , Laura Napoleone  1   2 , Jordi Gratacós-Ginès  1   2 , Octavi Bassegoda  1   2 , Marta Cervera  2   3   4 , Martina Pérez  1   4 , Ana Belén Rubio  1   4 , Emma Avitabile  1   2 , Manuel Morales-Ruiz  2   3   5 , Isabel Graupera  1   2   3 , Elisa Pose  1   2   3 , Patrick S Kamath  6 , Pere Ginès  1   2   3   4
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Sequential changes in urinary biomarker levels in patients with cirrhosis and severe hepatorenal syndrome

Cristina Solé et al. Liver Int. 2021 Nov.

Abstract

Whether tubular injury develops in patients with acute kidney injury owing to hepatorenal syndrome (AKI-HRS) is controversial. We performed repeated measurements of biomarkers of tubular injury during a 14-day period in 60 patients with cirrhosis and AKI (34 with AKI-HRS meeting the classical definition of type 1 HRS and 26 with AKI owing to acute tubular necrosis, AKI-ATN). Nineteen of 34 patients had resolution of AKI-HRS, while the remainder had persistent AKI-HRS. The persistence of AKI-HRS was associated with remarkably high short-term mortality. There were no significant differences in urinary NGAL or IL-18 between patients with resolution vs those with persistent AKI-HRS throughout the 14-day period. By contrast, biomarker levels were significantly lower in AKI-HRS, even if persistent, compared to AKI-ATN. These findings are highly suggestive of lack of significant tubular injury in AKI-HRS and could be of value in the clinical decision between combined liver-kidney or liver transplantation alone in patients with cirrhosis and AKI candidates to transplantation.

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References

REFERENCES

    1. Ginès P, Solà E, Angeli P, Wong F, Nadim MK, Kamath PS. Hepatorenal syndrome. Nat Rev Dis Prim. 2018;4:23. doi:10.1038/s41572-018-0022-7
    1. Simonetto DA, Gines P, Kamath PS. Hepatorenal syndrome: pathophysiology, diagnosis, and management. BMJ. 2020;370:m2687.
    1. Angeli P, Garcia-Tsao G, Nadim MK, Parikh CR. News in pathophysiology, definition and classification of hepatorenal syndrome: a step beyond the International Club of Ascites (ICA) consensus document. J Hepatol. 2019;71:811-822. 10.1016/j.jhep.2019.07.002
    1. Nadim MK, Yuri S, Genyk CT. Impact of the etiology of acute kidney injury on outcomes following liver transplantation: acute tubular necrosis versus hepatorenal syndrome. Liver Transpl. 2012;18:530-548.
    1. European Association for the Study of the Liver. EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis. J Hepatol. 2010;53:397-417.

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