Renal function evaluation in liver cirrhosis: Preliminary report on the effect of the Royal Free Hospital Cirrhosis Glomerular Filtration Rate on the Model for End-Stage Liver Disease (MELD)

2018 ◽  
Vol 48 ◽  
pp. e18-e20
Author(s):  
Gaetano Bergamaschi ◽  
Michela Masotti ◽  
Gino Roberto Corazza
Hepatology ◽  
2003 ◽  
Vol 38 ◽  
pp. 418-419
Author(s):  
K BAMBHA ◽  
W KIM ◽  
J BENSON ◽  
P KAMATH ◽  
E DICKSON ◽  
...  

Author(s):  
Ahmed Abdelrahman Mohamed Baz ◽  
Rana Magdy Mohamed ◽  
Khaled Helmy El-kaffas

Abstract Background Liver cirrhosis is a multi-etiological entity that alters the hepatic functions and vascularity by varying grades. Hereby, a cross-sectional study enrolling 100 cirrhotic patients (51 males and 49 females), who were diagnosed clinically and assessed by model for end-stage liver disease (MELD) score, then correlated to the hepatic Doppler parameters and ultrasound (US) findings of hepatic decompensation like ascites and splenomegaly. Results By Doppler and US, splenomegaly was evident in 49% of patients, while ascites was present in 44% of them. Increased hepatic artery velocity (HAV) was found in70% of cases, while 59% showed reduced portal vein velocity (PVV). There was a statistically significant correlation between HAV and MELD score (ρ = 0.000), but no significant correlation with either hepatic artery resistivity index (HARI) (ρ = 0.675) or PVV (ρ =0.266). Moreover, HAV had been correlated to splenomegaly (ρ = 0.000), whereas HARI (ρ = 0.137) and PVV (ρ = 0.241) did not significantly correlate. Also, ascites had correlated significantly to MELD score and HAV (ρ = 0.000), but neither HARI (ρ = 0.607) nor PVV (ρ = 0.143) was significantly correlated. Our results showed that HAV > 145 cm/s could confidently predict a high MELD score with 62.50% and 97.62 % sensitivity and specificity. Conclusion Doppler parameters of hepatic vessels (specifically HAV) in addition to the US findings of hepatic decompensation proved to be a non-invasive and cost-effective imaging tool for severity assessment in cirrhotic patients (scored by MELD); they could be used as additional prognostic parameters for improving the available treatment options and outcomes.


Folia Medica ◽  
2012 ◽  
Vol 54 (4) ◽  
pp. 5-13 ◽  
Author(s):  
Bilyana H. Teneva

Abstract In liver cirrhosis patients awaiting liver transplantation, it is prognostically equally important to assess the renal function before and after transplantation. This is evidenced by the inclusion of serum creatinine in the Model for End-Stage Liver Disease (MELD) score. Most of the causes of renal failure in liver cirrhosis are functional, the acute kidney damage including prerenal azotemia, acute tubular necrosis and hepatorenal syndrome. A major index of the renal function, the glomerular filtration rate (GFR) is determined in a specific way in patients with liver cirrhosis. Clinically, serum creatinine is considered the best indicator of kidney function, although it is rather unreliable when it comes to early assessment of renal dysfunction. Most of the patients with liver cirrhosis have several concomitant conditions, which are the reason for the false low creatinine levels, even in the presence of moderate to severe kidney damage. This also holds for the creatinine clearance and creatinine-based estimation equations for assessment of the glomerular filtration rate (the Cockroft-Gault and MDRD formulas), which overestimate the real glomerular filtration. Clearance of exogenous markers is considered a gold standard, but the methods for their determination are rather costly and hard to apply. Alternative serum markers (e.g., cystatin C) have been used, but they should be better studied in cases of liver cirrhosis assessment.


2002 ◽  
Vol 97 (11) ◽  
pp. 2855-2860 ◽  
Author(s):  
Edoardo Giannini ◽  
Federica Botta ◽  
Emanuela Testa ◽  
Paola Romagnoli ◽  
Simone Polegato ◽  
...  

2012 ◽  
Vol 42 (5) ◽  
pp. 459-472 ◽  
Author(s):  
Hiroaki Takaya ◽  
Masahito Uemura ◽  
Yoshihiro Fujimura ◽  
Masanori Matsumoto ◽  
Tomomi Matsuyama ◽  
...  

2010 ◽  
Vol 52 (4) ◽  
pp. 523-528 ◽  
Author(s):  
Young-Suk Lim ◽  
Timothy S. Larson ◽  
Joanne T. Benson ◽  
Patrick S. Kamath ◽  
Walter K. Kremers ◽  
...  

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