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

Cristina Solé; Ann T. Ma; Elsa Solà; Marta Carol; Núria Fabrellas; Adrià Juanola; Laura Napoleone; Jordi Gratacós-Ginès; Octavi Bassegoda; Marta Cervera; Martina Pérez; Ana Belén Rubio; Emma Avitabile; Manuel Morales-Ruiz; Isabel Graupera; Elisa Pose; Patrick S. Kamath; Pere Ginès

doi:10.1111/liv.15069

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

Cristina Solé, Ann T. Ma, Elsa Solà, Marta Carol, Núria Fabrellas, Adrià Juanola, Laura Napoleone, Jordi Gratacós-Ginès, Octavi Bassegoda, Marta Cervera, Martina Pérez, Ana Belén Rubio, Emma Avitabile, Manuel Morales-Ruiz, Isabel Graupera, Elisa Pose, Patrick S. Kamath, Pere Ginès

Gastroenterology and Hepatology

Research output: Contribution to journal › Article › peer-review

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.

Original language	English (US)
Pages (from-to)	2729-2732
Number of pages	4
Journal	Liver International
Volume	41
Issue number	11
DOIs	https://doi.org/10.1111/liv.15069
State	Published - Nov 2021

ASJC Scopus subject areas

Hepatology

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10.1111/liv.15069

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Solé, C., Ma, A. T., Solà, E., Carol, M., Fabrellas, N., Juanola, A., Napoleone, L., Gratacós-Ginès, J., Bassegoda, O., Cervera, M., Pérez, M., Rubio, A. B., Avitabile, E., Morales-Ruiz, M., Graupera, I., Pose, E., Kamath, P. S., & Ginès, P. (2021). Sequential changes in urinary biomarker levels in patients with cirrhosis and severe hepatorenal syndrome. Liver International, 41(11), 2729-2732. https://doi.org/10.1111/liv.15069

Solé, C, Ma, AT, Solà, E, Carol, M, Fabrellas, N, Juanola, A, Napoleone, L, Gratacós-Ginès, J, Bassegoda, O, Cervera, M, Pérez, M, Rubio, AB, Avitabile, E, Morales-Ruiz, M, Graupera, I, Pose, E, Kamath, PS & Ginès, P 2021, 'Sequential changes in urinary biomarker levels in patients with cirrhosis and severe hepatorenal syndrome', Liver International, vol. 41, no. 11, pp. 2729-2732. https://doi.org/10.1111/liv.15069

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title = "Sequential changes in urinary biomarker levels in patients with cirrhosis and severe hepatorenal syndrome",

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.",

author = "Cristina Sol{\'e} and Ma, {Ann T.} and Elsa Sol{\`a} and Marta Carol and N{\'u}ria Fabrellas and Adri{\`a} Juanola and Laura Napoleone and Jordi Gratac{\'o}s-Gin{\`e}s and Octavi Bassegoda and Marta Cervera and Martina P{\'e}rez and Rubio, {Ana Bel{\'e}n} and Emma Avitabile and Manuel Morales-Ruiz and Isabel Graupera and Elisa Pose and Kamath, {Patrick S.} and Pere Gin{\`e}s",

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year = "2021",

month = nov,

doi = "10.1111/liv.15069",

language = "English (US)",

volume = "41",

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T1 - Sequential changes in urinary biomarker levels in patients with cirrhosis and severe hepatorenal syndrome

AU - Solé, Cristina

AU - Ma, Ann T.

AU - Solà, Elsa

AU - Carol, Marta

AU - Fabrellas, Núria

AU - Juanola, Adrià

AU - Napoleone, Laura

AU - Gratacós-Ginès, Jordi

AU - Bassegoda, Octavi

AU - Cervera, Marta

AU - Pérez, Martina

AU - Rubio, Ana Belén

AU - Avitabile, Emma

AU - Morales-Ruiz, Manuel

AU - Graupera, Isabel

AU - Pose, Elisa

AU - Kamath, Patrick S.

AU - Ginès, Pere

PY - 2021/11

Y1 - 2021/11

N2 - 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.

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

Abstract

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