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10.1002/hep.26980 http://scihub22266oqcxt.onion/10.1002/hep.26980 C4065642!4065642!24375576     free     free     free Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       Hepatology 2014 ; 60 (2): 622-32 Nephropedia Template TP {{tp|p=24375576|t=2014. Kidney Biomarkers and Differential Diagnosis of Patients With Cirrhosis and Acute Kidney Injury |pdf=|usr=}}{{24375576}} gab.com Text Kidney Biomarkers and Differential Diagnosis of Patients With Cirrhosis and Acute Kidney Injury JO: Hepatology http://www.kidney.de/pget.php?&tw=1&pmid=24375576 #FOAvip Acute kidney injury (AKI) is common in patients with cirrhosis and associated with significant mortality. The most common etiologies of AKI in this setting are pre-renal azotemia (PRA), acute tubular necrosis (ATN) and hepatorenal syndrome (HRS). Accurately distinguishing the etiology of AKI is critical as treatments differ markedly. However, establishing an accurate differential diagnosis is extremely challenging. Urinary biomarkers of kidney injury distinguish structural from functional causes of AKI and may facilitate more accurate and rapid diagnoses. We conducted a multi-center, prospective cohort study of patients with cirrhosis and AKI assessing multiple biomarkers for differential diagnosis of clinically adjudicated AKI. Patients (n=36) whose creatinine returned to within 25% of their baseline within 48 hours were diagnosed with PRA. 76 patients with progressive AKI were diagnosed via blinded retrospective adjudication. Of these progressors, thirty-nine (53%) patients were diagnosed with ATN, 19 (26%) with PRA and 16 (22%) with HRS. Median values for neutrophil gelatinase-associated lipocalin (NGAL), interleukin-18 (IL-18), kidney injury molecule-1 (KIM-1), liver-type fatty acid binding protein (L-FABP) and albumin differed between etiologies and were significantly higher in patients adjudicated with ATN. The fractional excretion of sodium (FENa) was lowest in patients with HRS, 0.10%, but did not differ between those with PRA, 0.27%, or ATN, 0.31%, p=0.54. The likelihood of being diagnosed with ATN increased step-wise with number of biomarkers above optimal diagnostic cutoffs.Conclusion: Urinary biomarkers of kidney injury are elevated in patients with cirrhosis and AKI due to ATN. Incorporating biomarkers into clinical decision making has the potential to more accurately guide treatment by establishing which patients have structural injury underlying their AKI. Further research is required to document biomarkers specific to HRS. Twit Text FOAVip Kidney Biomarkers and Differential Diagnosis of Patients With Cirrhosis and Acute Kidney Injury ????Hepatology http://www.kidney.de/pget.php?&tw=1&pmid=24375576 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=24375576 #FOAvip English Wikipedia <ref>{{Cite pmid|24375576}}</ref> Kidney Biomarkers and Differential Diagnosis of Patients With Cirrhosis and Acute Kidney Injury #MMPMID24375576 Belcher JM; Sanyal AJ; Peixoto AJ; Perazella MA; Lim J; Thiessen-Philbrook H; Ansari N; Coca SG; Garcia-Tsao G; Parikh CR Hepatology 2014[Aug]; 60 (2): 622-32 PMID24375576show ga Acute kidney injury (AKI) is common in patients with cirrhosis and associated with significant mortality. The most common etiologies of AKI in this setting are pre-renal azotemia (PRA), acute tubular necrosis (ATN) and hepatorenal syndrome (HRS). Accurately distinguishing the etiology of AKI is critical as treatments differ markedly. However, establishing an accurate differential diagnosis is extremely challenging. Urinary biomarkers of kidney injury distinguish structural from functional causes of AKI and may facilitate more accurate and rapid diagnoses. We conducted a multi-center, prospective cohort study of patients with cirrhosis and AKI assessing multiple biomarkers for differential diagnosis of clinically adjudicated AKI. Patients (n=36) whose creatinine returned to within 25% of their baseline within 48 hours were diagnosed with PRA. 76 patients with progressive AKI were diagnosed via blinded retrospective adjudication. Of these progressors, thirty-nine (53%) patients were diagnosed with ATN, 19 (26%) with PRA and 16 (22%) with HRS. Median values for neutrophil gelatinase-associated lipocalin (NGAL), interleukin-18 (IL-18), kidney injury molecule-1 (KIM-1), liver-type fatty acid binding protein (L-FABP) and albumin differed between etiologies and were significantly higher in patients adjudicated with ATN. The fractional excretion of sodium (FENa) was lowest in patients with HRS, 0.10%, but did not differ between those with PRA, 0.27%, or ATN, 0.31%, p=0.54. The likelihood of being diagnosed with ATN increased step-wise with number of biomarkers above optimal diagnostic cutoffs.Conclusion: Urinary biomarkers of kidney injury are elevated in patients with cirrhosis and AKI due to ATN. Incorporating biomarkers into clinical decision making has the potential to more accurately guide treatment by establishing which patients have structural injury underlying their AKI. Further research is required to document biomarkers specific to HRS. äKidney Biomarkers and Differential Diagnosis of Patients With Cirrhosi(epmc).pdf DeepDyve Pubget Overpricing