Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Accumulating evidence suggests that extracellular volume (ECV) may be governed in part by a natriuretic hormone. To study its possible role in oedema formation plasma fractions IV from patients with the nephrotic syndrome, with cirrhosis of the liver, and with idiopathic oedema were studied for their effects on frog skin Na-transport and on rat renal Na-excretion. Plasma fractions IV from ECV-expanded healthy subjects and patients with aldosteronoma significantly inhibited PD and SCC and in the rat increased urinary flow, CH29, and UNaV. Neither antinatriferic nor natriuretic activities were observed in patients with the nephrotic syndrome or liver cirrhosis. In patients with idiopathic oedema recurrent episodes of fluid retention up to 9 percent of b.wt. followed by spontaneous natriuresis were well correlated with antinatriferic plasma activity. The results suggest that ECV in healthy subjects may be governed in part by a natriuretic hormone which is absent in ECV-expansion due to oedema. However, this mechanism may operate appropriately, though at an elevated threshold, in patients with idiopathic oedema.
Proc Eur Dial Transplant Assoc 1976
PMID:Plasma natriuretic activity in oedematous states. 108 25

Ten patients with chronic hepatic disease (CHD) were compared with 34 non-CHD (N) pts. All patients underwent a peritoneal equilibration test; the asymptotic curves for small solutes transport were transformed into straight lines; protein transport was also expressed as a straight line; the slopes of these linear functions were used as index of solute transfer. CHD patients showed increased UF and transport of all solutes. The well-known relationships between UF and glucose absorption and between UF and dialysate sodium concentration were observed in N, but not in CHD patients. In patients without hepatic disease there was also a relationship between UF and the glucose transport slope, which was not observed in CHD pts. These results are probably due to the influence of hepatic lymph production plus increased lymphatic removal, observed in non uremic patients affected by cirrhosis, on the mechanisms of water and solute transport in CAPD. CHD patients can be managed either with CAPD or with short frequent exchanges. Ascites production can be evaluated by the difference between the observed UF in a patient with CHD and the expected UF in N patients.
Adv Perit Dial 1990
PMID:Transport of water and solutes in uremic patients with chronic hepatic disease in CAPD. 198 13

The frequency of mesangial IgA deposition was examined in 250 consecutive autopsy cases without known renal disease. Diffuse granular mesangial deposits of IgA were detected in 12 of 250 cases (4.8%). In six patients IgA deposits were associated with liver cirrhosis. Six patients (2.4%) suffered from various other conditions including endocarditis, bronchial asthma, cardiovascular disease, and neoplasia. Two of these patients had completely negative urine analysis on repeated investigations, whereas three patients exhibited microscopic haematuria and/or mild proteinuria. IgA1 was the major constituent in all specimens. C3c deposits in glomeruli were detected in one kidney. Our findings indicate that clinically overt renal disease is present in only a limited proportion of individuals with mesangial IgA deposits. Apparently, it represents the tip of an iceberg.
Nephrol Dial Transplant 1989
PMID:Frequency of mesangial IgA deposits in a non-selected autopsy series. 251 84

The effect of the long-acting somatostatin analogue SMS 201-995 on renal function was investigated in nine cirrhotic patients with ascites, low urine output, low serum sodium, and normal serum creatinine. SMS 201-995, infused at 40 micrograms/h for 2 h, produced a significant increase in urine volume, a significant decrease in urine osmolality, and a significant increase in creatinine clearance. These changes, although less pronounced, persisted 24 h after the infusion of the analogue. No significant changes in free water clearance, urinary sodium excretion or serum sodium were noted. The effects of SMS 201-995 might be attributed to an improvement of renal haemodynamics through inhibition of vasoconstrictor systems acting in cirrhosis. It is concluded that SMS 201-995 may have a role in the treatment of the renal abnormalities complicating liver disease.
Nephrol Dial Transplant 1988
PMID:Enhancement of renal function by a long-acting somatostatin analogue in patients with decompensated cirrhosis. 314 15

Six HBsAg negative patients with cirrhosis of the liver (CL) presented with recurrent bouts of palpable purpura in the legs due to small vessel leucocytoclastic vasculitis. In addition, all patients had renal failure, proteinuria and microhaematuria. Renal biopsy disclosed either diffuse proliferative (3 cases) or focal necrotising glomerulonephritis with crescents (2 cases). One patient had IgM-IgG mixed cryoglobulinaemia (type II). Four patients died of complications of their CL. Hepatocellular carcinoma was found in 1 case. In the patient without renal biopsy renal function improved following steroids and cyclophosphamide. The pathogenesis of this syndrome of cutaneous vasculitis with severe glomerular involvement in CL is unknown but could be immune-complex mediated.
Proc Eur Dial Transplant Assoc Eur Ren Assoc 1985
PMID:Renal involvement in a syndrome of vasculitis complicating HBsAg negative cirrhosis of the liver. 399 59

Hepatitis B virus infection is responsible for both morbidity and mortality in kidney transplant recipients. Adenine arabinoside 5'-monophosphate (ARA-AMP), a synthetic purine nucleotide with anti-viral activity, leads to a sustained interruption of HBV replication in approximately 40% of immunocompetent patients. We report the results of a pilot study using ARA-AMP to treat HBV-related chronic active hepatitis in kidney transplant recipients. Ten patients (2 females and 8 males, mean age 44 years, mean time post-transplantation 163 months) received a 28-day course of ARA-AMP intramuscularly: 5 mg/kg twice daily for the first 5 days during hospitalization and subsequently 5 mg/kg once daily at home for the remaining 23 days. Mean follow-up was 18 months, ranging from 7 to 28 months. All patients but one had biopsy-proven chronic hepatitis, including five cases of cirrhosis. All patients had been chronic HBs Ag carriers for more than 1 year and had active replication as assessed by the presence of serum HBV DNA (mean titre, 270 pg/ml, ranging from 12 to 997 pg/ml, Genostics method). HBe Ag was present in 7 of the 10 patients. Pretreatment creatinine was normal. In four of the 10 patients, HBV DNA became undetectable respectively 1, 1, 5, and 11 months after beginning ARA-AMP. In five patients, HBV DNA decreased during ARA-AMP therapy but subsequently increased although no change was noted during the follow-up period.(ABSTRACT TRUNCATED AT 250 WORDS)
Nephrol Dial Transplant 1994
PMID:Effectiveness of adenine arabinoside 5'-monophosphate in kidney transplant recipients with chronic active hepatitis B. 752 77

A variety of renal diseases can be associated with end-stage liver diseases requiring orthotopic liver transplantation (OLT), including cirrhosis-associated glomerulonephritis (GN), and nephropathy unrelated to the liver disease. A retrospective survey showed that nine patients undergoing liver transplantation in our centre had histologically proven GN or interstitial nephritis with renal failure and/or nephrotic-range proteinuria, and experienced severe complications post-OLT since nephrotoxic immunosuppressive drugs (CsA and FK506) could not be adequately given. Four of the nine patients died. Therefore, combined liver-kidney transplantation has been suggested as first choice treatment in such patients. From January 1990 to February 1994, in patients with end-stage liver disease referred for OLT, and who presented with unexplained renal function impairment and/or significant proteinuria, severe nephropathy was confirmed by renal biopsy in nine: four mesangiocapillary GN with immune deposits, one membranous nephropathy, two diabetic glomerulosclerosis and two interstitial nephritis. All underwent liver transplantation immediately followed by kidney transplantation. The postoperative period was uneventful, and neither death nor renal failure were recorded. Combined transplantation resulted in all patients in the normalization of renal function, and in the disappearance of proteinuria within the first postoperative month. From 6 months to 4 years post-transplant, the renal function remained within normal ranges in all patients. Routine renal transplant biopsy was performed in two patients with pre-transplant cirrhosis-associated GN, and showed no evidence of recurrence of the original nephropathy. We conclude that combined liver-kidney transplantation is an adequate therapeutic option in patients with end-stage liver disease associated with advanced kidney disease.(ABSTRACT TRUNCATED AT 250 WORDS)
Nephrol Dial Transplant 1995
PMID:Combined liver and kidney transplantation in patients with chronic nephritis associated with end-stage liver disease. 852 84

Hepatic cirrhosis and clinically active hepatitis due to HBV or HCV infection clearly contra-indicate kidney transplantation. More controversial is the attitude to be adopted towards candidates with clinically quiescent chronic HBV or HCV infection. The presence of the HBs antigen does not adversely affect survival or increase morbidity on maintenance haemodialysis, at least during the first decade. After transplantation, by contrast, the long-term outcome of HBV infection is undoubtedly worse than on haemodialysis: more patients develop chronic hepatitis and eventually die from liver disease. The risk of fatal liver disease after transplantation is greater in patients with markers of active viral replication before transplant and in those with severe histological liver lesions. Pretransplant candidates should be warned of this significant risk factor. Comparison of survival of HCV-infected patients on haemodialysis and after transplantation is not yet possible. The outcome of HCV infection after transplantation appears less severe than that of HBV infection: the survival of anti-HCV-positive patients is similar to that of anti-HCV-negative patients, at least during the first decade after transplantation. Liver biochemical abnormalities, serological markers and detection of HCV RNA are of little value to identify patients at greater risk of poor outcome after transplantation. Only liver biopsy might help identify such patients. Both efficacy and risks of antiviral therapies are yet to be properly assessed during haemodialysis. Preliminary evidence suggests that interferon therapy given after transplantation entails an unacceptable rate of deterioration in graft function.(ABSTRACT TRUNCATED AT 250 WORDS)
Nephrol Dial Transplant 1995
PMID:Implications of chronic hepatitis B or hepatitis C infection for renal transplant candidates. 852 6

Only 15 cases of any etiology of Neisseria meningitidis peritonitis have been reported in the world literature since the first case in 1917. We report the first case in a continuous ambulatory peritoneal dialysis (CAPD) patient presenting with abdominal pain and cloudy peritoneal dialysis fluid. A lumbar puncture was normal. The patient died despite therapy with ceftriaxone. Autopsy confirmed this was a case of primary N. meningitidis peritonitis. Of the 15 cases of N. meningitidis reported as a cause of peritonitis, 9 patients were less than age 35 with no underlying diseases. Five cases were associated with cirrhosis or alcohol abuse. Two cases were associated with meningitis, and 1 patient was on steroid therapy for systemic lupus erythematosus. Nine of 15 patients recovered. In conclusion, N. meningitidis should be considered as another rare cause of peritonitis in patients on CAPD.
Adv Perit Dial 1995
PMID:Neisseria meningitidis peritonitis in a CAPD patient: first case report and review of the literature. 853 96

Our objective was to analyze the survival of diabetic patients on renal replacement therapy and to compare their survival on extracorporeal and on peritoneal dialysis. All data regarding diabetic patients admitted to dialysis between 1 January 1983 and 31 December 1993 were collected by means of individual patient questionnaires sent to all of the 44 regional Renal Units (100% answers) of Lombardy, Italy. Cox proportional hazards model, stepwise procedure, was applied in order to select the covariates significantly associated with survival. Age (at baseline), sex, type of diabetes, initial modality of treatment (hemodialysis or peritoneal dialysis), and initial clinical risk factors (malignancies, serious heart disease, vascular disease, cirrhosis of the liver, cachexia) were considered. Descriptive analysis of survival was performed using the Kaplan-Meier technique. The survival of all diabetic patients (895) was 86.5% at one year, 52% at three years, and 34% at five years. The main causes of the 488 deaths of diabetic patients were cardiovascular diseases (56%), cachexia (18%), and infections (11%). The relative death risk of patients on peritoneal dialysis versus those on hemodialysis, after taking into account the main comorbid conditions, did not significantly differ from 1, as estimated by the Cox proportional hazards regression model. Five-year survival of diabetic patients was 34%, and no differences were found between peritoneal dialysis and hemodialysis as far as mortality is concerned.
Perit Dial Int 1996
PMID:Survival of diabetic patients on peritoneal dialysis or hemodialysis. 872 8


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