Renal dysfunction in cirrhosis.


PURPOSE OF REVIEW:Renal dysfunction causes significant morbidity in cirrhotic patients. Diagnosis is challenging because it is based on serum creatinine, which is used to calculate estimated glomerular filtration rate, which itself is not an ideal measure of renal function in patients with cirrhosis. Finding the exact cause of renal injury in patients with cirrhosis remains problematic due to the limitations of the current diagnostic tests. The purpose of this review is to highlight studies used to diagnose renal dysfunction in patients with renal dysfunction and review current treatments. RECENT FINDINGS:New diagnostic criteria and classification of renal dysfunction, especially for acute kidney injury (AKI), have been proposed in hopes of optimizing treatment and improving outcomes. New biomarkers that help to differentiate structural from functional AKI in cirrhotic patients have been developed, but require further investigation. Vasoconstrictors are the most commonly recommended treatment of hepatorenal syndrome (HRS). Given the high mortality in patients with type 1 HRS, all patients with HRS should be evaluated for liver transplantation. When renal dysfunction is considered irreversible, combined liver-kidney transplantation is advised. SUMMARY:Development of new biomarkers to differentiate the different types of AKI in cirrhosis holds promise. Early intervention in cirrhotic patients with renal dysfunction offers the best hope of improving outcomes.


Urrunaga NH,Mindikoglu AL,Rockey DC




Has Abstract


2015-05-01 00:00:00












  • Management of symptom complexes in primary biliary cholangitis.

    abstract:PURPOSE OF REVIEW:Primary biliary cholangitis (PBC) is a rare autoimmune liver disease that increasingly is diagnosed at early stages of disease. Although survival has improved, a majority suffers from one or more symptom complexes associated with PBC. Much remains unknown about the mechanisms, significance, or effecti...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Kuo A,Kuo A,Bowlus CL

    更新日期:2016-05-01 00:00:00

  • Biliary endoscopy.

    abstract::Highlighting this year was the National Institutes of Health (NIH) State-of-the-Science Conference on endoscopic retrograde cholangiopancreatography. The panel addressed controversies in biliary endoscopy and set the framework for future funding for clinical research endeavors. With respect to biliary endoscopy, the l...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章


    authors: Beilstein MC,Kochman ML

    更新日期:2003-05-01 00:00:00

  • Cryotherapy for Barrett's esophagus and esophageal cancer.

    abstract:PURPOSE OF REVIEW:To summarize the recent literature on endoscopic spray cryotherapy for the treatment of Barrett's esophagus and esophageal cancer. RECENT FINDINGS:Endoscopic spray cryotherapy is a relatively new ablative modality for the treatment of gastrointestinal diseases. Spray cryotherapy rapidly cools tissues...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Greenwald BD,Dumot JA

    更新日期:2011-07-01 00:00:00

  • Autoimmune pancreatitis.

    abstract:PURPOSE OF REVIEW:Autoimmune pancreatitis (AIP) is an increasingly recognized clinical condition. Our objective is to provide a concise review of the advances in the past year in our understanding of AIP. RECENT FINDINGS:In a hospital survey from Japan, the prevalence of AIP was estimated at 0.82 per 100,000 individua...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Pannala R,Chari ST

    更新日期:2008-09-01 00:00:00

  • Complications of bariatric surgery.

    abstract:PURPOSE OF REVIEW:Morbid obesity is an epidemic in the United States and parts of Europe, with severe health consequences. As the number of patients undergoing bariatric surgery has increased dramatically, it is crucial for the gastroenterologist caring for these patients to have a better understanding of the procedure...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Lee CW,Kelly JJ,Wassef WY

    更新日期:2007-11-01 00:00:00

  • Update on viral hepatitis in 2004.

    abstract:PURPOSE OF REVIEW:This article highlights recent advances in viral hepatitis published from December 2003 to November 2004. Studies reporting novel and clinically relevant findings were selected after a PubMed search. The aim is to provide an up-to-date summary of important developments in viral hepatitis. RECENT FIND...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Fung SK,Lok AS

    更新日期:2005-05-01 00:00:00

  • MicroRNAs and cholestatic liver diseases.

    abstract:PURPOSE OF REVIEW:To highlight the increasing evidence supporting the concept that microRNAs (miRNAs) are involved in the cause and pathogenesis of cholestatic liver disorders. RECENT FINDINGS:miRNAs play a key role in maintaining bile acid homeostasis and modulating pathological processes associated to liver cholesta...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Marin JJ,Bujanda L,Banales JM

    更新日期:2014-05-01 00:00:00

  • Immunoglobulin G4-associated cholangitis.

    abstract:PURPOSE OF REVIEW:Immunoglobulin G4-associated cholangitis is a recently identified clinical entity characterized by infiltration of immunoglobulin G4 -bearing plasma cells in bile ducts and other affected tissues. This review is focused mainly on the most recent studies published during the last 2 years that have incr...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Björnsson E

    更新日期:2008-05-01 00:00:00

  • What is left of the endoscopic antireflux devices?

    abstract:PURPOSE OF REVIEW:We critically analyze existing endoscopy-based interventions for gastroesophageal reflux disease (GERD). The focus is on the effectiveness of available procedures and to delineate goals for future research. RECENT FINDINGS:Recent evaluations of the EndoCinch system reveal poor long-term results and n...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Jafri SM,Arora G,Triadafilopoulos G

    更新日期:2009-07-01 00:00:00

  • Intestinal lymphoid tissues: is variety an asset or a liability?

    abstract:PURPOSE OF REVIEW:Advances in our understanding of lymphoid tissue development has led to an appreciation of the variety of these structures in the intestinal mucosa. This knowledge has translated into more critical analysis of the function of mucosal lymphoid tissues and may lead to manipulation of development of thes...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Newberry RD

    更新日期:2008-03-01 00:00:00

  • The evolution of natural history of primary sclerosing cholangitis.

    abstract:PURPOSE OF REVIEW:Primary sclerosing cholangitis (PSC) is a rare, idiopathic biliary disease often with an insidious onset, variable disease course, and premature death related to benign and malignant PSC-related sequelae. This review aims to discuss the epidemiology, clinical variants, and natural history of PSC, inco...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Takakura WR,Tabibian JH,Bowlus CL

    更新日期:2017-03-01 00:00:00

  • Novel imaging modalities for immune cell monitoring in the intestine.

    abstract:PURPOSE OF REVIEW:The introduction of novel molecular imaging modalities that can not only define disease states on the basis of structural changes and morphology, but also allow in-vivo visualization and characterization of molecular and biochemical alterations on a cellular level add a new dimension to our current di...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Atreya R,Neurath MF

    更新日期:2014-11-01 00:00:00

  • The gut microbiome as a predictor of low fermentable oligosaccharides disaccharides monosaccharides and polyols diet efficacy in functional bowel disorders.

    abstract:PURPOSE OF REVIEW:Fermentable oligosaccharides disaccharides monosaccharides and polyols (FODMAP) dietary restriction ameliorates irritable bowel syndrome (IBS) symptoms; however, not all individuals with IBS respond. Given the gut microbiome's role in carbohydrate fermentation, investigators have evaluated whether the...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Chumpitazi BP

    更新日期:2020-03-01 00:00:00

  • The role of altered microbial signaling via mutant NODs in intestinal inflammation.

    abstract:PURPOSE OF REVIEW:Recently, a new class of intracellular pattern recognition receptors belonging to the family of nucleotide binding and oligomerization domain (NOD)-like receptors that includes NOD1, NOD2 and IPAF has been described. These proteins are involved in recognizing bacterial components or their degradation ...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Rescigno M,Nieuwenhuis EE

    更新日期:2007-01-01 00:00:00

  • Sphincter of Oddi dysfunction: sphincter of Oddi dysfunction or discordance? What is the state of the art in 2018?

    abstract:PURPOSE OF REVIEW:To review important manuscripts published over the previous 2 years relative to sphincter of Oddi dysfunction (SOD). RECENT FINDINGS:The long-term outcomes of the Evaluating Predictors and Interventions of SOD (EPISOD) trial further substantiated results from the initial EPISOD study, reinforcing tha...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Hyun JJ,Kozarek RA

    更新日期:2018-09-01 00:00:00

  • Chest pain of esophageal origin.

    abstract::The treatment of patients with unexplained chest pain is difficult and challenging. After a cardiac etiology has been ruled out, a diligent search for an esophageal etiology-gastroesophageal reflux disease, motility abnormalities, or esophageal hypersensitivity-should be undertaken with judicious use of a diagnostic (...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章


    authors: Katz PO

    更新日期:1999-07-01 00:00:00

  • Approaches to endoscopic ampullectomy.

    abstract:PURPOSE OF REVIEW:Ampullary tumors, usually adenomas, are often encountered during endoscopic evaluation, especially in patients with familial adenomatous polyposis (FAP). Because of the risk of progression to adenocarcinoma, ampullary adenomas should be treated. Endoscopic therapy is an appropriate option and recent e...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章


    authors: Wong RF,DiSario JA

    更新日期:2004-09-01 00:00:00

  • Colonoscopy: new approaches to better outcomes.

    abstract:PURPOSE OF REVIEW:Prevention of colorectal cancer relies on the detection and removal of colorectal neoplasia. Recent advances in mucosal imaging and inspection techniques have increased the detection of small and diminutive colorectal polyps with unknown clinical impact. The ability to accurately predict whether a pol...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Coe SG,Wallace MB

    更新日期:2012-01-01 00:00:00

  • Endoscopic diagnosis of gastrointestinal stromal cell tumors.

    abstract:PURPOSE OF REVIEW:To outline the recommended course of action when a subepithelial lesion is encountered during upper endoscopy. It will focus on the endoscopic and endosonographic features common to gastrointestinal stromal tumors, and the optimal tests performed to confirm the diagnosis of a gastrointestinal stromal ...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Rodriguez SA,Faigel DO

    更新日期:2007-09-01 00:00:00

  • Fatty liver and the metabolic syndrome.

    abstract:PURPOSE OF REVIEW:Nonalcoholic fatty liver disease and its subset nonalcoholic steatohepatitis represent the liver manifestations of insulin resistance. This review briefly summarizes advances in our understanding of the pathogenesis of nonalcoholic fatty liver disease and its prevalence, natural history and treatment....

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Neuschwander-Tetri BA

    更新日期:2007-03-01 00:00:00

  • The intestinal flora in inflammatory bowel disease: normal or abnormal?

    abstract:PURPOSE OF REVIEW:The human gut is the natural habitat for a large and dynamic bacterial community. There is a substantial body of evidence implicating the resident flora in the pathogenesis of chronic intestinal inflammation. This review discusses the possible role of a microbial imbalance in the pathophysiology of in...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Guarner F

    更新日期:2005-07-01 00:00:00

  • The assessment and management of defecatory dysfunction: a critical appraisal.

    abstract:PURPOSE OF REVIEW:To summarize the advances in diagnostic modalities and management options for defecatory dysfunction and highlight the areas in need of further research. RECENT FINDINGS:The diagnostic utility of high-resolution anorectal manometry (ARM), which has emerged as a promising tool for the diagnosis of def...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Neshatian L

    更新日期:2018-01-01 00:00:00

  • Medical management of inflammatory bowel disease: old and new perspectives.

    abstract::The treatment of inflammatory bowel disease is a continually evolving area and a major focus of the current literature in gastroenterology. As further information is gained in the areas of etiology, pathophysiology, and natural history of the disease, new agents are developed, and management strategies are revised. Th...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章


    authors: Nash CL,Sutherland LR

    更新日期:2001-07-01 00:00:00

  • Pathogenesis of Helicobacter pylori infection.

    abstract::Intensive investigation into the interactions of Helicobacter pylori with the human host during the period of this review has led to several important developments in our understanding of H. pylori pathogenesis. There is direct evidence to support a central role for bacterial adhesion to host gastric epithelial Lewis ...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章


    authors: Wilson KT,Fantry GT

    更新日期:1999-01-01 00:00:00

  • Endoscopic treatment of colonic obstruction.

    abstract:PURPOSE OF REVIEW:Over the past 15 years, great strides have been made in the nonsurgical management of malignant large bowel obstruction. Progress continues, particularly in the area of self-expanding metal stents. The purpose of this review is to assess the available endoscopic techniques for colonic decompression an...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Dekovich AA

    更新日期:2009-01-01 00:00:00

  • Animal models of cholangiocarcinoma.

    abstract:PURPOSE OF REVIEW:Even though recent accumulated data can help to understand fundamental molecular mechanisms of progression of cholangiocarcinoma (CCA), its incidence and mortality still keep increasing worldwide with poor prognosis. As appropriate animal disease models are critical to fill the gap between the finding...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Ko KS,Peng J,Yang H

    更新日期:2013-05-01 00:00:00

  • New mediators of immunity and inflammation in inflammatory bowel disease.

    abstract:PURPOSE OF REVIEW:In both Crohn's disease and ulcerative colitis, the tissue damage results from an inappropriate or exaggerated immune response to antigens of the gut microflora. This review summarizes current knowledge regarding the role of immune-inflammatory mediators in the pathogenesis of inflammatory bowel disea...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Monteleone G,Fina D,Caruso R,Pallone F

    更新日期:2006-07-01 00:00:00

  • Nod-like receptors in intestinal host defense: controlling pathogens, the microbiota, or both?

    abstract:PURPOSE OF REVIEW:Nod-like receptors (NLRs) are intracellular innate immune sensors of microbes and danger signals that control multiple aspects of inflammatory responses. We review the evidence that highlights the critical importance of NLRs in the host response to intestinal pathogens. Moreover, we discuss the potent...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Robertson SJ,Girardin SE

    更新日期:2013-01-01 00:00:00

  • Iron absorption and metabolism.

    abstract:PURPOSE OF REVIEW:Intestinal iron absorption is an essential physiological process that is regulated by the liver-derived peptide hepcidin. This review will describe recent advances in hepcidin biology and enterocyte iron transport. RECENT FINDINGS:Hepcidin acts as a repressor of iron absorption and its expression in ...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Anderson GJ,Frazer DM,McLaren GD

    更新日期:2009-03-01 00:00:00

  • Clinical nutrition for the gastroenterologist: the physiologic rationale for providing early nutritional therapy to the hospitalized patient.

    abstract:PURPOSE OF REVIEW:Conflicting reports in the literature have been misinterpreted by clinicians, who conclude that nutritional therapy for the hospitalized patient is of marginal value. The true benefit of such therapy is derived from the provision of early enteral nutrition. This article describes the physiologic respo...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: McClave SA,Omer E

    更新日期:2020-03-01 00:00:00