2026-04-17T07:59:25Zhttps://recercat.cat/oai/request

oai:recercat.cat:2445/1724052026-04-15T20:20:09Zcom_2072_1057col_2072_478917col_2072_478921

urn:hdl:2445/172405 Characterization of inflammatory response in hepatorenal syndrome: Relationship with kidney outcome and survival. Solé Padullés, Cristina Solà, Elsa Huelin, Patricia Carol, Marta Moreira, Rebeca Cereijo, Unai Mas, José Manuel Graupera, Isabel Pose Méndez, Elisa Napoleone, Laura de la Prada, Gloria Juanola Mayos, Adrià Fabrellas i Padrès, Núria Torres, Ferran Morales Ruiz, Manuel Farrés, Judith Jiménez Povedano, Wladimiro Ginès i Gibert, Pere Cirrosi hepàtica Síndrome hepatorenal Inflamació Hepatic cirrhosis Hepatorenal syndrome Inflammation Background: Several lines of evidence indicate that decompensated cirrhosis is characterized by the presence of systemic inflammation. Hepatorenal syndrome (HRS-AKI) is a unique type of renal failure that occurs at late stages of cirrhosis. However, confirmation of the presence and significance of such inflammatory response in HRS-AKI is lacking. Aim and methods: To characterize the systemic inflammatory response, as estimated by measuring a large number of cytokines, in 161 patients hospitalized for an acute decompensation of cirrhosis: 44 patients without acute kidney injury (AKI), 63 patients with hypovolaemia-induced AKI and 58 patients with HRS-AKI. Results: HRS-AKI was characterized by an altered cytokine profile compared to the other two groups, particularly IL-6, IL-8, TNF-α, VCAM-1, fractalkine and MIP-1α. The inflammatory response was not related to presence of bacterial infection, concomitant acute-on-chronic liver failure or severity of renal dysfunction. Patients who responded to terlipressin and albumin had only a decrease in TNF-α and RANTES after treatment without changes in other cytokines. Interestingly, patients with persistent HRS-AKI had higher levels of IP-10 and VCAM-1 compared to those with resolution of HRS-AKI. VCAM-1 was also an independent predictor of 3-month mortality. A systems biology analysis approach showed that the inflammatory status of HRS-AKI was similar to that of chronic nonhepatic inflammatory conditions, such as lupus erythematosus or inflammatory bowel disease. Conclusion: Hepatorenal syndrome is characterized by a marked systemic inflammatory state, reminiscent of that of nonhepatic inflammatory diseases, that correlates with patient outcomes. 2020-11-30T15:10:26Z 2020-11-30T15:10:26Z 2018-12-29 2020-11-30T15:10:26Z info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Reproducció del document publicat a: https://doi.org/10.1111/liv.14037 Liver International, 2018, vol. 39, num. 7, p. 1246-1255 https://doi.org/10.1111/liv.14037 info:eu-repo/grantAgreement/EC/H2020/731875/EU//LIVERHOPE cc-by (c) Solé Padullés, et. al., 2018 http://creativecommons.org/licenses/by/3.0/es/ info:eu-repo/semantics/openAccess John Wiley & Sons Articles publicats en revistes (Medicina)