2024
Association of HRS-AKI with Mortality in Patients with Cirrhosis Requiring Renal Replacement Therapy: Results from the HRS-HARMONY Consortium.
Cama-Olivares A, Ouyang T, Takeuchi T, St Hillien S, Robinson J, Chung R, Cullaro G, Karvellas C, Levitsky J, Orman E, Patidar K, Regner K, Saly D, Sawinski D, Sharma P, Teixeira J, Ufere N, Velez J, Wadei H, Wahid N, Allegretti A, Neyra J, Belcher J. Association of HRS-AKI with Mortality in Patients with Cirrhosis Requiring Renal Replacement Therapy: Results from the HRS-HARMONY Consortium. Kidney360 2024 PMID: 39348201, DOI: 10.34067/kid.0000000589.Peer-Reviewed Original ResearchEtiology of AKIHRS-AKIAKI-RRTRenal replacement therapyContinuous RRTIntermittent hemodialysisAdult patientsHospitalized patientsAKI etiologyReplacement therapyAssociated with increased 90-day mortalityMulticenter retrospective cohort studyNon-HRS-AKIAssociated with increased mortalityConsecutive adult patientsRetrospective cohort studyHospital network systemHepatorenal syndromeContemporary cohortInpatient populationMechanical ventilationRRT modalityCohort studyClinical variablesPrimary outcomeOutcomes of patients with alcohol‐associated hepatitis and acute kidney injury – Results from the HRS Harmony Consortium
T. A, Allegretti A, Cullaro G, Ouyang T, Asrani S, Chung R, Przybyszewski E, Wilechansky R, Robinson J, Sharma P, Simonetto D, Jalal P, Orman E, Wadei H, St. Hillien S, Saly D, Ufere N, Dageforde L, Regner K, Belcher J, Patidar K, Consortium F. Outcomes of patients with alcohol‐associated hepatitis and acute kidney injury – Results from the HRS Harmony Consortium. Alimentary Pharmacology & Therapeutics 2024, 60: 778-786. PMID: 39010302, PMCID: PMC11349455, DOI: 10.1111/apt.18159.Peer-Reviewed Original ResearchAlcohol-associated hepatitisAcute kidney injuryAcute kidney injury phenotypesHepatorenal syndromeMELD-NaDevelopment of acute kidney injuryCumulative incidence of deathConsecutive adult patientsOutcomes of patientsAlcohol Abuse and Alcoholism (NIAAANon-AH groupRenal replacement therapyPresence of AHAcute tubular necrosisRetrospective cohort studyPredictors of mortalityIncidence of deathAKI stageClinical courseReplacement therapyAdult patientsKidney injuryCumulative incidencePoor prognosisTubular necrosisAcute kidney injury in patients with cirrhosis: Acute Disease Quality Initiative (ADQI) and International Club of Ascites (ICA) joint multidisciplinary consensus meeting
Nadim M, Kellum J, Forni L, Francoz C, Asrani S, Ostermann M, Allegretti A, Neyra J, Olson J, Piano S, VanWagner L, Verna E, Akcan-Arikan A, Angeli P, Belcher J, Biggins S, Deep A, Garcia-Tsao G, Genyk Y, Gines P, Kamath P, Kane-Gill S, Kaushik M, Lumlertgul N, Macedo E, Maiwall R, Marciano S, Pichler R, Ronco C, Tandon P, Velez J, Mehta R, Durand F. Acute kidney injury in patients with cirrhosis: Acute Disease Quality Initiative (ADQI) and International Club of Ascites (ICA) joint multidisciplinary consensus meeting. Journal Of Hepatology 2024, 81: 163-183. PMID: 38527522, PMCID: PMC11193657, DOI: 10.1016/j.jhep.2024.03.031.Peer-Reviewed Original ResearchAcute Disease Quality InitiativeInternational Club of AscitesAcute kidney injuryHRS-AKIQuality InitiativeHepatorenal syndromePost-discharge follow-upKidney injuryMultidisciplinary consensus meetingRisk of progression to chronic kidney diseaseProgression to chronic kidney diseasePhenotypes of acute kidney injuryFollow-up of patientsBridge to liver transplantationIncreased in-hospital morbidityIn-hospital morbidityPost-discharge follow-up of patientsChronic kidney diseaseMortality riskConsensus meetingInternational ClubCurative optionSplanchnic vasoconstrictorsAdvanced cirrhosisLiver transplantationHepatorenal Syndrome Type 1: Diagnosis and Treatment
Belcher J. Hepatorenal Syndrome Type 1: Diagnosis and Treatment. Advances In Kidney Disease And Health 2024, 31: 100-110. PMID: 38649214, DOI: 10.1053/j.akdh.2023.05.001.Peer-Reviewed Original ResearchConceptsAcute kidney injuryHepatorenal syndromeKidney injuryFunctional acute kidney injuryUrinary biomarkers of kidney injuryAssociated with significant morbidityFractional excretion of sodiumNeutrophil gelatinase-associated lipocalinDiagnostic criteriaBiomarkers of kidney injuryMultiple urinary biomarkersOptimal dosing strategiesExcretion of sodiumPoint-of-care ultrasoundAccurate differential diagnosisAnalog of vasopressinSets of diagnostic criteriaAdvanced cirrhosisAlbumin administrationSignificant morbidityVolume resuscitationTherapeutic optionsDosing strategiesFractional excretionDifferential diagnosis
2023
Incidence and outcomes of acute kidney injury including hepatorenal syndrome in hospitalized patients with cirrhosis in the US
Patidar K, Belcher J, Regner K, St. Hillien S, Simonetto D, Asrani S, Neyra J, Sharma P, Velez J, Wadei H, Nadim M, Chung R, Seethapathy R, Parada X, Ouyang T, Ufere N, Robinson J, Diaz P, Wilechansky R, Przybyszewski E, Smith T, Ali A, Orman E, Schulz P, Siddiqui S, Shabbir R, Liu L, Cama-Olivares A, Flannery A, Baker M, Gunasekaran D, Aswine A, Issa R, Li J, Verma S, Chalmers D, Varghese V, Lam W, Mohamed M, Kovacic R, Gaddy A, Attieh R, Cortes P, Semnani S, Wang L, Khemichian S, Allegretti A, consortium F. Incidence and outcomes of acute kidney injury including hepatorenal syndrome in hospitalized patients with cirrhosis in the US. Journal Of Hepatology 2023, 79: 1408-1417. PMID: 37517455, PMCID: PMC10807505, DOI: 10.1016/j.jhep.2023.07.010.Peer-Reviewed Original ResearchConceptsEtiology of AKIHRS-AKISubdistribution hazard ratiosHepatorenal syndromePrerenal AKIKidney injuryHigh morbidityIncidence ratePractice patternsSimilar outcomesHigher AKI stageAcute kidney injuryRetrospective cohort studyAcute tubular necrosisConsecutive adult patientsEtiology of injuryAKI stageAKI definitionLiver transplantAdult patientsCohort studyHazard ratioSevere complicationsTubular necrosisComplete responseHepatorenal Syndrome Pathophysiology, Diagnosis, and Treatment
Belcher J. Hepatorenal Syndrome Pathophysiology, Diagnosis, and Treatment. Medical Clinics Of North America 2023, 107: 781-792. PMID: 37258014, DOI: 10.1016/j.mcna.2023.03.009.Peer-Reviewed Original ResearchConceptsAcute kidney injuryHepatorenal syndromeCombination of midodrineFirst-line standardPooling of bloodAnalog of vasopressinIntravenous albuminKidney injuryLiver transplantationVasoconstrictor agentsDefinitive treatmentPathophysiologic cascadeSplanchnic systemSyndrome pathophysiologyArterial volumeTreatmentTerlipressinCirrhosisMidodrineOctreotidePatientsTransplantationPathophysiologySyndromeInjury
2021
Terlipressin and the Treatment of Hepatorenal Syndrome: How the CONFIRM Trial Moves the Story Forward
Belcher JM, Parada XV, Simonetto DA, Juncos LA, Karakala N, Wadei HM, Sharma P, Regner KR, Nadim MK, Garcia-Tsao G, Velez JCQ, Parikh SM, Chung RT, Allegretti AS, Investigators H. Terlipressin and the Treatment of Hepatorenal Syndrome: How the CONFIRM Trial Moves the Story Forward. American Journal Of Kidney Diseases 2021, 79: 737-745. PMID: 34606933, DOI: 10.1053/j.ajkd.2021.08.016.Peer-Reviewed Original ResearchConceptsAcute kidney injuryHepatorenal syndromeRespiratory adverse eventsPrimary end pointFirst-line therapyMean arterial pressureSympathetic nervous systemSynthetic vasopressin analogueAdvanced cirrhosisHRS reversalAldosterone systemKidney injuryLack of evidenceAdverse eventsMortality benefitPortal pressureArterial pressureFulminant formSplanchnic systemSignificant morbidityRenal vasculatureVasodilatory substancesApparent increased rateTerlipressinCONFIRM trialsUrinary NGAL as a Diagnostic and Prognostic Marker for Acute Kidney Injury in Cirrhosis: A Prospective Study
Allegretti AS, Parada XV, Endres P, Zhao S, Krinsky S, St. Hillien SA, Kalim S, Nigwekar SU, Flood JG, Nixon A, Simonetto DA, Juncos LA, Karakala N, Wadei HM, Regner KR, Belcher JM, Nadim MK, Garcia-Tsao G, Velez JCQ, Parikh SM, Chung RT. Urinary NGAL as a Diagnostic and Prognostic Marker for Acute Kidney Injury in Cirrhosis: A Prospective Study. Clinical And Translational Gastroenterology 2021, 12: e00359. PMID: 33979307, PMCID: PMC8116001, DOI: 10.14309/ctg.0000000000000359.Peer-Reviewed Original ResearchConceptsNeutrophil gelatinase-associated lipocalinUrinary neutrophil gelatinase-associated lipocalinAcute kidney injuryAcute tubular necrosisPrerenal acute kidney injuryHepatorenal syndromeKidney injuryC-statisticManagement of AKITypes of AKIEnd-stage liver disease (MELD) scoreTransplant-free survivalLiver Disease scoreMedian serum creatinineGelatinase-associated lipocalinPrediction of mortalityNet reclassification indexDiscrimination incrementProspective cohortSerum creatinineTubular necrosisProspective studyReclassification indexUnadjusted analysesPrognostic marker
2018
Acute Kidney Injury and Liver Disease: Incidence, Pathophysiology, Prevention/Treatment, and Outcomes
Belcher J, Parikh C. Acute Kidney Injury and Liver Disease: Incidence, Pathophysiology, Prevention/Treatment, and Outcomes. 2018, 113-131. DOI: 10.1007/978-1-4939-8628-6_7.Peer-Reviewed Original ResearchAcute kidney injuryAcute tubular necrosisHepatorenal syndromeKidney injuryDefinition of AKIRecent consensus criteriaStructural kidney injurySpontaneous bacterial peritonitisPortal hypertension resultsPrevention/treatmentMultiple urinary biomarkersAKI etiologyCreatinine cutoffRenal hypoperfusionGastrointestinal bleedingPrerenal azotemiaRenal functionSecondary insultsTubular necrosisBacterial peritonitisFractional excretionHypertension resultsPathophysiologic cascadeCommon etiologyLiver disease
2016
Urine Interleukin 18 and Lipocalin 2 Are Biomarkers of Acute Tubular Necrosis in Patients With Cirrhosis: A Systematic Review and Meta-analysis
Puthumana J, Ariza X, Belcher JM, Graupera I, Ginès P, Parikh CR. Urine Interleukin 18 and Lipocalin 2 Are Biomarkers of Acute Tubular Necrosis in Patients With Cirrhosis: A Systematic Review and Meta-analysis. Clinical Gastroenterology And Hepatology 2016, 15: 1003-1013.e3. PMID: 28013112, PMCID: PMC5474196, DOI: 10.1016/j.cgh.2016.11.035.Peer-Reviewed Original ResearchConceptsNeutrophil gelatinase-associated lipocalinAcute tubular necrosisUrine levelsUrine biomarkersSystematic reviewKidney impairmentKidney injuryTubular necrosisLipocalin-2Development of ATNAUC valuesEtiology of AKIUrine interleukin-18Acute kidney injuryGelatinase-associated lipocalinShort-term mortalityLogistic mixed-effects modelsHepatorenal syndromeCause mortalityPrerenal azotemiaCommon complicationInterleukin-18Prospective studyPatient outcomesCommon cause
2015
Acute Kidney Injury in Liver Disease: Role of Biomarkers
Belcher JM. Acute Kidney Injury in Liver Disease: Role of Biomarkers. Advances In Kidney Disease And Health 2015, 22: 368-375. PMID: 26311598, DOI: 10.1053/j.ackd.2015.06.009.BooksConceptsAcute kidney injuryEtiology of AKINeutrophil gelatinase-associated lipocalinAcute tubular necrosisGelatinase-associated lipocalinHepatorenal syndromeKidney injuryPrerenal azotemiaTubular necrosisFractional excretionInterleukin-18Urinary neutrophil gelatinase-associated lipocalinProgression of AKIKidney tubular injurySetting of cirrhosisOverall poor outcomeRole of biomarkersStandard diagnostic toolAdvanced cirrhosisAKI etiologyCommon complicationTubular injuryCommon etiologyLiver diseasePoor outcomeCreatinine Change on Vasoconstrictors as Mortality Surrogate in Hepatorenal Syndrome: Systematic Review & Meta-Analysis
Belcher JM, Coca SG, Parikh CR. Creatinine Change on Vasoconstrictors as Mortality Surrogate in Hepatorenal Syndrome: Systematic Review & Meta-Analysis. PLOS ONE 2015, 10: e0135625. PMID: 26295585, PMCID: PMC4546623, DOI: 10.1371/journal.pone.0135625.Peer-Reviewed Original ResearchConceptsDelta creatinineHepatorenal syndromeRelative riskSerum creatininePost-treatment mortalityVasoconstrictor therapyRandomized trialsHRS type 1Completion of treatmentWeb of ScienceRenal functionCreatinine changesOverall mortalitySevere complicationsControl armTreatment periodVasoconstrictor medicationCreatinineElectronic databasesMeta-AnalysisSystematic reviewMortalityType 1PatientsSignificant mortality
2014
Kidney biomarkers and differential diagnosis of patients with cirrhosis and acute kidney injury
Belcher JM, Sanyal AJ, Peixoto AJ, Perazella MA, Lim J, Thiessen‐Philbrook H, Ansari N, Coca SG, Garcia‐Tsao G, Parikh CR, Consortium F. Kidney biomarkers and differential diagnosis of patients with cirrhosis and acute kidney injury. Hepatology 2014, 60: 622-632. PMID: 24375576, PMCID: PMC4065642, DOI: 10.1002/hep.26980.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAcute-Phase ProteinsAdultAgedAlbuminuriaBiomarkersCreatinineDiagnosis, DifferentialFatty Acid-Binding ProteinsFemaleGlomerular Filtration RateHepatitis A Virus Cellular Receptor 1HumansInterleukin-18KidneyLipocalin-2LipocalinsLiver CirrhosisMaleMembrane GlycoproteinsMiddle AgedProspective StudiesProto-Oncogene ProteinsReceptors, VirusSodiumConceptsAcute kidney injuryAcute tubular necrosisKidney injury molecule-1Neutrophil gelatinase-associated lipocalinHepatorenal syndromePrerenal azotemiaKidney injuryDifferential diagnosisUrinary biomarkersEtiology of AKIProgressive acute kidney injuryLiver-type fatty acidOptimal diagnostic cutoffInjury molecule-1Prospective cohort studyGelatinase-associated lipocalinAccurate differential diagnosisClinical decision makingNumber of biomarkersCohort studyTubular necrosisFractional excretionCommon etiologyInterleukin-18Kidney biomarkersIs There a Role for Dialysis in Patients with Hepatorenal Syndrome Who Are Not Liver Transplant Candidates?
Belcher JM. Is There a Role for Dialysis in Patients with Hepatorenal Syndrome Who Are Not Liver Transplant Candidates? Seminars In Dialysis 2014, 27: 288-291. PMID: 24620917, DOI: 10.1111/sdi.12224.Commentaries, Editorials and LettersConceptsLiver transplant candidatesHepatorenal syndromeTransplant candidatesPatientsSyndromeDialysis