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Query: UMLS:C0023890 (cirrhosis)
42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Emphysematous pyelonephritis is a severe infection characterized by the presence of gas within the renal parenchyma and perirenal tissues. Two cases of this disease are presented. They were the 16th and 17th case reported in Japan. Case 1 was a 63-year-old woman with diabetes mellitus and liver cirrhosis. She was hospitalized for abdominal pain and anuria. Renal X-rays showed a gas shadow in and around the left kidney, but no evidence of upper urinary tract obstruction. Although hemodialysis was done, she died of heart failure. Case 2 was a 54-year-old man with diabetes mellitus was admitted with the complaint of fever and left abdominal pain. Renal X-rays showed a gas shadow in and around the left kidney but no evidence of upper urinary tract obstruction. He was treated with intensive antibiotic therapy, control of blood sugar, intravenous drips and percutaneous drainage. Clinical features improved, but deteriorated after 40 days of therapy. The gas shadow remained unchanged on CT scanning, and aortography showed the occlusion of the left renal artery. Nephrectomy was done after 50 days. Seventeen cases of emphysematous pyelonephritis in the literature including our cases are reviewed, especially the choice of the treatment is discussed.
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PMID:[Two cases of emphysematous pyelonephritis--considerations on the choice of treatment]. 359 89

An anuric ESRD patient on chronic hemodialysis with liver cirrhosis and refractory ascites was treated with ultrafiltration followed by head-out water immersion (HWI) and a new period of ultrafiltration. Despite anuria and the absence of peripheral edema, 4 h of HWI significantly raised the central venous pressure, diminished the abdominal girth by 5%, and successfully transfered at least 2.4 liters of ascitic fluid to the intravascular space made available to ultrafiltration. Dialysis or ultrafiltration alone were not effective in removing this amount of fluid or in reducing ascites.
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PMID:Water immersion in an anuric cirrhotic patient. 371 43

Eighteen mixed-breed beef cattle died as the result of consuming "tacky lithium grease" discarded from a rubber reclaiming plant. Four experimental groups of mature cattle were given oral doses of a lithium salt at levels of 0, 20, 500, and 700 mg/kg body weight. Although all animals in the 250 mg/kg group showed signs of intoxication, the signs were mild and transient. Doses of 500 and 700 mg/kg proved toxic and fatal. Signs, serum levels, and tissue-organ deposition were dose and time-related. Signs of intoxication were salivation, depression, anorexia, hypodipsia, anuria, and diarrhea. The high dose group also showed severe depression and ataxia. The highest mean lithium serum values were 19, 40, and 54 ppm for the 250, 500, and 700 mg/kg groups, respectively. Postmortem and histopathologic examinations revealed dose-related gastroenteritis, slight interstitial nephritis, and hepatic cirrhosis. Tissue residues of lithium were in striated muscle (86.8 ppm), heart (79.3 ppm), liver (68.7 ppm), kidney (67.1 ppm) , and brain (51.8 ppm), in the high dose group. Since serum levels of cattle consuming the "tacky lithium grease" were 0.49 ppm of lithium, we believe other contaminants in this discarded grease may have caused or enhanced the toxic effect of lithium.
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PMID:Lithium toxicity in cattle. 740 86

Acute renal failure (ARF) associated with liver disease is a commonly encountered clinical problem of varied etiology and high mortality. We have prospectively analyzed patients with liver disease and ARF to determine the etiology, clinical spectrum, prognosis and factors affecting the outcome. Other than hepatorenal syndrome patients, out of 221 cases, 66 developed ARF secondary to various liver disease like cirrhosis (n = 29, mortality 8, risk factors-older age p < 0.01, grade III/IV encephalopathy p < 0.05), fulminant hepatic failure (n = 25, mortality 15, risk factor-prolonged prothrombin time p < 0.01), and obstructive jaundice (n = 12, mortality 7, risk factor-sepsis p < 0.01). In these three groups the factors leading to ARF were volume depletion (24), gastrointestinal bleed (28), sepsis (34), drugs (27) [aminoglycosides (9) and NSAID (18)] along with hyperbilirubinemia. Various types of ARF with contemporaneous liver injury were malaria (n = 37, mortality 15, risk factors-higher bilirubin p < 0.001, higher creatinine p < 0.05, anuria p < 0.05 and dialysis dependency p < 0.05), sepsis (n = 36, mortality 22, risk factors-age p < 0.001, higher bilirubin p < 0.01, oliguria p < 0.05), hypovolemia with ischemic hepatic injury (n = 14, mortality 5, risk factors-higher creatinine p < 0.05 and SGPT p < 0.01), acute pancreatitis (n = 12, mortality 4, risk factors-higher bilirubin p < 0.001, higher SGPT p < 0.01, dialysis dependency p < 0.05), rifampicin toxicity (n = 10, no mortality), paroxysmal nocturnal hemoglobinuria (n = 3, no mortality), CuSO4 poisoning (n = 3 mortality 2), post abortal (n = 11, mortality 6, risk factors higher creatinine p < 0.05 and SGPT p < 0.01), ARF following delivery including HELLP syndrome (n = 12, mortality 4, risk factors-higher bilirubin p < 0.01 and SGPT p < 0.01), and of uncertain etiology (n= 14 mortality 4). 133 patients (60.2%), required hemodialysis hemodialfiltration or peritoneal dialysis. ARF associated with liver disease is having high mortality (42.5%). Avoidance of dehydration, hypotension, nephrotoxic drugs and sepsis, with promote dialytic support are necessary to reduce mortality and morbidity.
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PMID:Acute renal failure associated with liver disease in India: etiology and outcome. 1104 Dec 94

Endotoxins and cytokines play an important role in multiple organ failure pathogenesis in patients with severe Gram-negative bacterial infection. We present a clinical case where an oXiris hemofilter was used for continuous renal replacement therapy (CRRT) treatment in a patient with septic shock after liver transplantation. A 35-year-old man with a 20-year history of hepatitis B presented with jaundice, loss of appetite, and decreased urine output. He was diagnosed with decompensated cirrhosis with acute-on-chronic liver failure, and liver transplantation was indicated. The day after surgery, he developed hyperthermia, hypotension, anuria, and a progressive increase in blood inflammatory markers and creatinine. Combined with the donor source and blood culture results, septic shock after transplantation was considered. The patient was immediately treated with endotoxin and cytokine adsorption CRRT (oXiris hemofilter) with tigecycline, caspofungin, and ganciclovir as anti-infectives. After 48 hours on CRRT, his blood pressure gradually stabilized, the CLIF Consortium Acute-on-Chronic Liver Failure score decreased from 63 to 43. Procalcitonin, endotoxin, and the inflammatory factors interleukin (IL)-6 and IL-10 also decreased gradually. The patient's liver and kidney functions were completely restored. Our experience suggests that oXiris CRRT combined with antibacterial therapy is an effective treatment for septic shock after liver transplantation.
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PMID:Septic shock after liver transplantation successfully treated with endotoxin and cytokine adsorption continuous renal replacement therapy: a case report and literature review. 3268 65