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In severe alcohol-related hepatitis, acute kidney injury is prevalent, associated with mortality independent of liver disease severity, and can be predicted using IL-8 and micro-RNAs.
Tyson, Luke D; Atkinson, Stephen; Hunter, Robert W; Allison, Michael; Austin, Andrew; Dear, James W; Forrest, Ewan; Liu, Tong; Lord, Emma; Masson, Steven; Nunes, Joao; Richardson, Paul; Ryder, Stephen D; Wright, Mark; Thursz, Mark; Vergis, Nikhil.
Afiliación
  • Tyson LD; Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
  • Atkinson S; The Liver Unit, St Mary's Hospital, London, UK.
  • Hunter RW; Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
  • Allison M; The Liver Unit, St Mary's Hospital, London, UK.
  • Austin A; Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
  • Dear JW; Cambridge NIHR Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, UK.
  • Forrest E; Department of Hepatology, Royal Derby Hospital, Derby, UK.
  • Liu T; Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
  • Lord E; Department of Hepatology, Glasgow Royal Infirmary, Glasgow, UK.
  • Masson S; University of Glasgow, Glasgow, UK.
  • Nunes J; Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
  • Richardson P; Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
  • Ryder SD; Department of Hepatology, Newcastle Freeman Hospital, Newcastle upon Tyne, UK.
  • Wright M; Meso Scale Diagnostics, Gaithersburg, USA.
  • Thursz M; Department of Hepatology, The Royal Liverpool University Hospital, Liverpool, UK.
  • Vergis N; NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust and the University of Nottingham, Queens Medical Centre, Nottingham, UK.
Aliment Pharmacol Ther ; 58(11-12): 1217-1229, 2023 12.
Article en En | MEDLINE | ID: mdl-37781965
BACKGROUND: The prevalence, prediction and impact of acute kidney injury (AKI) in alcohol-related hepatitis (AH) is uncertain. AIMS: We aimed to determine AKI incidence; association with mortality; evaluate serum biomarkers and the modifying effects of prednisolone and pentoxifylline in the largest AH cohort to date. METHODS: Participants in the Steroids or Pentoxifylline for Alcoholic Hepatitis trial with day zero (D0) creatinine available were included. AKI was defined by modified International Club of Ascites criteria; incident AKI as day 7 (D7) AKI without D0-AKI. Survival was compared by Kaplan-Meier; mortality associations by Cox regression; associations with AKI by binary logistic regression; biomarkers by AUROC analyses. RESULTS: D0-AKI was present in 198/1051 (19%) participants; incident AKI developed in a further 119/571 (21%) with available data. Participants with D0-AKI had higher 90-day mortality than those without (32% vs. 25%, p = 0.008), as did participants with incident AKI compared to those without D0-AKI or incident AKI (47% vs. 25%, p < 0.001). Incident AKI was associated with D90 mortality adjusted for age and discriminant function (AHR 2.15, 1.56-2.97, p < 0.001); D0-AKI was not. Prednisolone therapy reduced incident AKI (AOR 0.55, 0.36-0.85, p = 0.007) but not mortality. D0 bilirubin and IL-8 combined, miR-6826-5p, and miR-6811-3p predicted incident AKI (AUROCs 0.726, 0.821, 0.770, p < 0.01). CONCLUSIONS: Incident AKI is associated with 90-day mortality independent of liver function. Prednisolone therapy was associated with reduced incident AKI. IL-8 and several miRNAs are potential biomarkers to predict AKI. Novel therapies to prevent incident AKI should be evaluated in AH to reduce mortality.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pentoxifilina / MicroARNs / Lesión Renal Aguda / Hepatitis Alcohólica Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Aliment Pharmacol Ther Asunto de la revista: FARMACOLOGIA / GASTROENTEROLOGIA / TERAPIA POR MEDICAMENTOS Año: 2023 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pentoxifilina / MicroARNs / Lesión Renal Aguda / Hepatitis Alcohólica Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Aliment Pharmacol Ther Asunto de la revista: FARMACOLOGIA / GASTROENTEROLOGIA / TERAPIA POR MEDICAMENTOS Año: 2023 Tipo del documento: Article Pais de publicación: Reino Unido