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












  • Functional dyspepsia.

    abstract:PURPOSE OF REVIEW:Functional dyspepsia is a common disorder, most of the time of unknown etiology and with variable pathophysiology. Therapy has been and still is largely empirical. Data from recent studies provide new clues for targeted therapy based on knowledge of etiology and pathophysiologic mechanisms. RECENT FI...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章


    authors: Kleibeuker JH,Thijs JC

    更新日期:2004-11-01 00:00:00

  • Intestinal absorption of water-soluble vitamins: an update.

    abstract:PURPOSE OF REVIEW:The molecular biology revolution has led to a significant improvement in our understanding of biological and physiological processes. Such expansion of knowledge has also covered the field of intestinal absorption of water-soluble vitamins and is the subject of this review. RECENT FINDINGS:Impressive...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Said HM,Mohammed ZM

    更新日期:2006-03-01 00:00:00

  • How soon should we start interventional feeding in the ICU?

    abstract:PURPOSE OF REVIEW:Nutrition in the critically ill patient remains a controversial topic. Most clinicians have viewed nutrition as part of patient care but not as a therapeutic intervention. Recent studies have looked at type and timing of nutrition to determine whether they affect important clinical outcomes. RECENT F...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Fremont RD,Rice TW

    更新日期:2014-03-01 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

  • Potential of multiomics technology in precision medicine.

    abstract:PURPOSE OF REVIEW:The 'precision medicine' refers to the generation of identification and classification criteria for advanced taxonomy of patients, exploiting advanced models to infer optimized clinical decisions for each disease phenotype. RECENT FINDINGS:The current article reviews new advances in the past 18 month...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Putignani L,Gasbarrini A,Dallapiccola B

    更新日期:2019-11-01 00:00:00

  • Role of innate immunity in cancer.

    abstract::Recently, much progress has been made in the field of tumor immunology. Much of this work has focused on understanding and exploiting the innate immune response to tumor cells. A novel human receptor-ligand system that mediates natural killer (NK) and gammadelta T-cell killing of carcinoma cells has been identified, a...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章


    authors: Golby SJ,Spencer J

    更新日期:2001-11-01 00:00:00

  • Role of visceral fat in colonic inflammation: from Crohn's disease to diverticulitis.

    abstract:PURPOSE OF REVIEW:The composition of activated adipose tissue with adipocytes secreting a broad spectrum of immune-modulatory adipokines next to adipose tissue-derived stromal cells and professional immune effector cells in the visceral fat creates a complex network of inflammatory processes shaping local immune respon...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Paeschke A,Erben U,Kredel LI,Kühl AA,Siegmund B

    更新日期:2017-01-01 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

  • Epidemiology of human noroviruses and updates on vaccine development.

    abstract:PURPOSE OF REVIEW:Noroviruses (NoVs) are the most common cause of epidemic and sporadic cases of acute gastroenteritis worldwide. This review summarizes recent NoV disease burden estimates, epidemiology findings and provides an update on virus-like particle (VLP) vaccine studies. RECENT FINDINGS:NoVs are the leading c...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Ramani S,Atmar RL,Estes MK

    更新日期:2014-01-01 00:00:00

  • Diet and colon: what matters?

    abstract:PURPOSE OF REVIEW:Colorectal cancer (CRC) is one of the most common cancers and the fourth leading cause of cancer-related deaths worldwide. Diet has a significant impact on the risk of developing CRC, but though processed meat is a known positive contributor, the effects of other dietary components are largely mixed. ...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Pan P,Yu J,Wang LS

    更新日期:2019-03-01 00:00:00

  • Endoscopic management of bariatric surgical complications.

    abstract:PURPOSE OF REVIEW:Bariatric surgery is recognized as the most effective treatment against obesity as it results in significant weight reduction and a high rate of remission of obesity-related comorbidities. However, bariatric surgery is not uncommonly associated with complications and an endoscopic approach to manageme...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Kumbhari V,Cai JX,Schweitzer MA

    更新日期:2015-09-01 00:00:00

  • Bile acid disease: the emerging epidemic.

    abstract:PURPOSE OF REVIEW:Our objective was to review advances in bile acids in health and disease published in the last 2 years. Bile acid diarrhea (BAD) is recognized as a common cause of chronic diarrhea, and its recognition has been facilitated by development of new screening tests. RECENT FINDINGS:Primary BAD can account...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Oduyebo I,Camilleri M

    更新日期:2017-05-01 00:00:00

  • The dark side of the colon: current issues surrounding the significance, prevalence, detection, diagnosis and management of serrated polyps.

    abstract:PURPOSE OF REVIEW:Hyperplastic polyps, once considered to have no malignant potential, are now recognized to be part of a larger group of polyps known as serrated polyps. Serrated polyps can progress to CRC through an epigenetic pathway known as CpG Island Methylator Phenotype (CIMP), characterized by hypermethylation ...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Lindholm CR,Anderson JC,Srivastava A

    更新日期:2019-01-01 00:00:00

  • Portal hypertension.

    abstract:PURPOSE OF REVIEW:Significant advances in the pathophysiology, diagnosis and management of the complications of portal hypertension that have occurred in the last year are reported. RECENT FINDINGS:The specific areas reviewed are those that refer to experimental studies aimed at modifying the factors that lead to port...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Garcia-Tsao G

    更新日期:2006-05-01 00:00:00

  • Metals and the liver.

    abstract:PURPOSE OF REVIEW:Hereditary liver diseases resulting in copper and iron overload may cause significant morbidity and mortality if not diagnosed and treated early. The goal of this review is to highlight the key publications on genetics, diagnosis and management of hemochromatosis and Wilson disease over the past 18 mo...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Maxwell KL,Kowdley KV

    更新日期:2012-05-01 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

  • 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

  • Pancreatic surgery.

    abstract:PURPOSE OF REVIEW:To summarize published research on pancreatic surgery over the past year. RECENT FINDINGS:Improvements in the treatment of patients with acute gallstone pancreatitis with regards to the timing of ERCP and cholecystectomy as well as management of pancreatic pseudocysts have been reported. It is often ...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Donahue TR,Reber HA

    更新日期:2010-09-01 00:00:00

  • Autoimmune liver disease.

    abstract:PURPOSE OF REVIEW:The aim of this article is to review studies that improve the diagnosis and treatment of autoimmune hepatitis and suggest new drug and molecular interventions. RECENT FINDINGS:Elderly patients have an indolent but aggressive disease that responds well to corticosteroid therapy. Variant syndromes are ...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Czaja AJ

    更新日期:2007-05-01 00:00:00

  • Clinical applications of submucosal endoscopy.

    abstract:PURPOSE OF REVIEW:Submucosal endoscopy with mucosal flap (SEMF), a new diagnostic and therapeutic intervention of flexible endoscopy, has been examined from the perspective of developmental laboratory work, procedural details, and results of early clinical experiences. RECENT FINDINGS:Diagnostic natural orifice transl...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Sumiyama K,Gostout CJ

    更新日期:2011-09-01 00:00:00

  • Diagnosis and therapy of esophageal vascular disorders.

    abstract:PURPOSE OF REVIEW:The most relevant studies concerning the diagnosis of esophageal varices, primary and secondary prophylaxis and treatment of variceal bleeding published in the last year are reported. RECENT FINDINGS:The specific areas reviewed are those that refer to studies on the noninvasive or minimally invasive ...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: de Franchis R,Dell'Era A

    更新日期:2007-07-01 00:00:00

  • Does everyone with inflammatory bowel disease need to be treated with combination therapy?

    abstract:PURPOSE OF REVIEW:This article describes the evolution of combination therapy in inflammatory bowel disease and how to determine when combination may not be necessary. RECENT FINDINGS:The combination of an immunosuppressive agent with an antibody to tumor necrosis factor has proven to be more effective than monotherap...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Bernstein CN

    更新日期:2016-07-01 00:00:00

  • Helicobacter pylori virulence factors: facts and fantasies.

    abstract:PURPOSE OF REVIEW:Virulence factors are related to the ability of a microbe to induce disease. True virulence factors must therefore have a disease association, an in-vivo correlate with disease such as increased mucosal inflammation, or both. RECENT FINDINGS:The cytotoxin-associated gene pathogenicity island; the out...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Lu H,Yamaoka Y,Graham DY

    更新日期:2005-11-01 00:00:00

  • Viral hepatitis.

    abstract::Viral hepatitis is still one of the most common causes of acute and chronic liver disease worldwide. Major advances have been made in our knowledge of these diseases, many during the past year. Molecular biology and clinical studies have improved our understanding of the mechanisms of antiviral drugs, as well as viral...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章


    authors: Regev A,Schiff ER

    更新日期:1999-05-01 00:00:00

  • Updates in biliary endoscopy 2006.

    abstract:PURPOSE OF REVIEW:Endoscopic retrograde cholangiopancreatography is reserved primarily for therapeutic reasons. Recent literature continues to support therapeutic uses of the technique. This review addresses the literature in the field of biliary endoscopy for the year 2006 and is intended to assist gastroenterologists...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Wamsteker EJ

    更新日期:2007-05-01 00:00:00

  • Mechanisms of autoimmune hepatitis.

    abstract:PURPOSE OF REVIEW:Autoimmune hepatitis (AIH) is a chronic disease characterized by a lymphocyte infiltrate in the liver. For decades, nonspecific immunosuppression has been used to limit chronic liver inflammation. The high risk of relapse, the treatments side effects, and the significant number of refractory patients ...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章


    authors: Cardon A,Conchon S,Renand A

    更新日期:2021-03-01 00:00:00

  • Gastroduodenal mucosal defense.

    abstract:PURPOSE OF REVIEW:The gastroduodenum has multiple means by which it resists injury from intrinsic and extrinsic factors, including gastric acid, nonsteroidal anti-inflammatory drugs, and Helicobacter pylori. We review recent insights into the mechanisms by which the gastroduodenum resists injury and discuss factors con...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Nayeb-Hashemi H,Kaunitz JD

    更新日期:2009-11-01 00:00:00

  • Celiac disease.

    abstract:PURPOSE OF REVIEW:Research in celiac disease is unraveling new findings at a high rate, and major advances seem to occur in all areas such as genetics, environmental factor, pathophysiology, and even prospective therapeutic implications. RECENT FINDINGS:New insight is being gained into the interplay between genetic an...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审


    authors: Guandalini S,Setty M

    更新日期:2008-11-01 00:00:00

  • Molecular-phylogenetic analyses of human gastrointestinal microbiota.

    abstract::Molecular-phylogenetic methods have revolutionized the analysis of complex microbial communities. Polymerase chain reaction amplification and phylogenetic analysis of small-subunit ribosomal RNA gene sequences allow microbes to be identified objectively, even in the absence of cultivation. Furthermore, the sequence in...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章


    authors: Frank DN,Pace NR

    更新日期:2001-01-01 00:00:00

  • Absorption of water-soluble vitamins.

    abstract::Water-soluble vitamins are required as enzyme cofactors in a wide variety of metabolic reactions. Riboflavin, niacin, and vitamin C are essential in redox reactions; thiamine and biotin are involved in macronutrient metabolism; and folate, vitamin B12, pyridoxine, and riboflavin play important roles in the regulation ...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章


    authors: Halsted CH

    更新日期:2003-03-01 00:00:00