Hepatorenal syndrome (HRS) is a functional reversible renal failure that occurs in patients with advanced liver cirrhosis or acute hepatic failure. The mean characteristic of HRS is renal ischemia secondary to hypotension and profound renal cortical vasoconstriction as a consequence of activation of systemic and local vasoconstrictors. Pharmacological treatment of HRS, using mostly terlipressin...

BACKGROUND Patients with renal failure are vulnerable to tuberculosis, a common worldwide infectious disease. In the growing dialysis population, the risk for tuberculosis among the associated sub-groups is important but unclear. This study investigated latent tuberculosis infection (LTBI) in patients with severe chronic kidney disease (CKD) and among dialysis-unit staff caring for patients on ...

Objective: To examine the factors affecting serum albumin level in uremic patients receiving continuous ambulatory peritoneal dialysis (CAPD). Methods: One hundred and twenty-five patients with end-stage renal disease on CAPD in our center were recruited for this cross-sectional study. Patients receiving CAPD for less than 12 months (n = 36) or receiving concurrent intermittent hemodialysis (n ...

OBJECTIVE We investigated the effects of inflammatory and nutritional status on the association between serum albumin and mortality in hemodialysis (HD) and peritoneal dialysis (PD) patients. DESIGN AND PATIENTS This was a prospective cohort study of incident dialysis patients starting HD or PD. Inflammation (C-reactive protein >or=5 or >or=10 mg/L), malnutrition (1 to 5 on the 7-point subjec...

Given that liver failure continues to pose an enormous clinical challenge, the concept of hepatic dialysis has enjoyed significant interest. In particular, many investigations have examined the therapeutic mechanisms and efficacy of artificial albumin dialysis based systems in acute on chronic liver failure, the results of which have been conflicting. Albumin dialysis systems do not appear to s...

BACKGROUND Elevated plasma concentrations of leptin, a hormone thought to regulate body composition by influencing food intake/metabolic rate, are prevalent in renal failure patients. The mechanism for these increases is not known, but evidence suggests that simple accumulation due to decreased elimination is insufficient explanation. METHODS We studied the incidence of hyperleptinaemia in 28...

M any in the nephrology community were surprised when the Hemodialysis (HEMO) Study, completed in 2002, supported the null hypothesis for each intervention, suggesting ceiling effects for both the dose of dialysis and membrane permeability (1). Neither increases in the dose (expressed as the product of dialyzer urea clearance and dialysis time factored for patient size) nor an improvement in di...

Extracorporeal liver support has been a much studied topic throughout the last 50 years. Albumin dialysis as a therapeutic option for patients with acute liver failure or acute decompensation of chronic liver disease was introduced in the mid-nineties. The Molecular Adsorbent Recirculating System (MARS) is based on the concept of albumin dialysis and allows for the removal of protein-bound as w...

OBJECTIVE Acute liver failure (ALF) is haemodynamically characterized by a hyperdynamic circulation. The aims of this study were to investigate the systemic and regional haemodynamics in ALF, to measure changes in nitric oxide metabolites (NOx) and to evaluate whether these haemodynamic disturbances could be attenuated with albumin dialysis. MATERIAL AND METHODS Norwegian Landrace pigs (23-30...