2024
Acute 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 transplantationP- 40 PENTOXIFYLLINE USE IN PATIENTS WITH ALCOHOL-ASSOCIATED HEPATITIS ADMITTED WITH ACUTE KIDNEY INJURY COULD DECREASE SURVIVAL: A GLOBAL STUDY
Idalsoaga F, Diaz L, Corsi O, Ayares G, Arnold J, Dunn W, Li Y, Singal A, Simonetto D, Ayala-Valverde M, Ramirez C, Morales-Arraez D, Zhang W, Qian S, Ahn J, Buryska S, Mehta H, Waleed M, Stefanescu H, Horhat A, Bumbu A, Agrawal B, Agrawal R, Cabezas J, Cuyàs B, Poca M, Pastor G, Sarin S, Maiwall R, Jalal P, La Tijera M, Kulkarni A, Rao N, Salazar P, Skladaný L, Bystrianska N, Prado V, Clemente-Sanchez A, Rincón D, Haider T, Chacko K, Romero G, Pollarsky F, Restrepo J, Toro L, Yaquich P, Mendizabal M, Garrido M, Marciano S, Dirchwolf M, Vargas V, Jimenez C, García-Tsao G, Ortiz G, Abraldes J, Kamath P, Shah V, Bataller R, Arab J. P- 40 PENTOXIFYLLINE USE IN PATIENTS WITH ALCOHOL-ASSOCIATED HEPATITIS ADMITTED WITH ACUTE KIDNEY INJURY COULD DECREASE SURVIVAL: A GLOBAL STUDY. Annals Of Hepatology 2024, 29: 101227. DOI: 10.1016/j.aohep.2023.101227.Peer-Reviewed Original ResearchAlcohol-associated hepatitisAcute kidney injurySevere AHPentoxifylline useLiver transplantationKidney injuryMaddrey's discriminant functionAssociated with increased mortalityHistory of cirrhosisSubgroup of patientsRetrospective cohort studyMultivariate-adjusted modelsEffect of pentoxifyllineAssociated with mortalityCompeting-risks modelMedian ageSerum creatinineMELD scoreUnivariate analysisCohort studyFemale sexPentoxifyllineDecreased survivalSevere entityPatients
2023
AGA Clinical Practice Update on the Use of Vasoactive Drugs and Intravenous Albumin in Cirrhosis: Expert Review
Garcia-Tsao G, Abraldes J, Rich N, Wong V. AGA Clinical Practice Update on the Use of Vasoactive Drugs and Intravenous Albumin in Cirrhosis: Expert Review. Gastroenterology 2023, 166: 202-210. PMID: 37978969, DOI: 10.1053/j.gastro.2023.10.016.Peer-Reviewed Original ResearchConceptsSpontaneous bacterial peritonitisAcute kidney injuryLarge-volume paracentesisEffective arterial blood volumeVasoactive drugsVariceal hemorrhageArterial blood volumeHRS-AKIUncomplicated ascitesIntravenous albuminVolume statusPractice UpdateBlood volumeChronic liver failure grade 3Best practice advice statementsClinical Practice Updates CommitteeEnd-stage liver diseaseAGA Clinical Practice UpdateForms of AKIIntensive care unit monitoringAGA Governing BoardCombination of vasoconstrictorsInitial endoscopic hemostasisPatient's volume statusClinical Practice UpdateControversies regarding albumin therapy in cirrhosis.
Trebicka J, Garcia-Tsao G. Controversies regarding albumin therapy in cirrhosis. Hepatology 2023 PMID: 37540192, DOI: 10.1097/hep.0000000000000521.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsSpontaneous bacterial peritonitisBacterial peritonitisAcute kidney injuryLarge-volume paracentesisSerum albumin levelChronic liver diseaseUse of albuminHepatorenal syndromeAdvanced cirrhosisAlbumin infusionKidney injuryAlbumin therapyAlbumin levelsAlbumin useProinflammatory stateLiver diseasePatient selectionVolume overloadPoor outcomeHigh oxidative stressCirrhosisPathophysiological relevanceOxidative stressPeritonitisAlbuminUpdate in the Treatment of the Complications of Cirrhosis
Abraldes J, Caraceni P, Ghabril M, Garcia-Tsao G. Update in the Treatment of the Complications of Cirrhosis. Clinical Gastroenterology And Hepatology 2023, 21: 2100-2109. PMID: 36972759, PMCID: PMC11097249, DOI: 10.1016/j.cgh.2023.03.019.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsTransjugular intrahepatic portosystemic shuntVariceal hemorrhageHepatic encephalopathyPre-emptive transjugular intrahepatic portosystemic shuntsAcute variceal hemorrhageCombination of terlipressinAcute kidney injuryComplications of cirrhosisSecond-line treatmentSignificant portal hypertensionFirst-line treatmentLeast common causePrognosis of patientsOrnithine L-aspartatePresence of varicesIntrahepatic portosystemic shuntStandard of careQuality of lifeCyanoacrylate injectionHepatorenal syndromeUncomplicated ascitesKidney injuryPortal hypertensionRefractory ascitesAlbumin useAcute Kidney Injury in Patients with Cirrhosis
Nadim M, Garcia-Tsao G. Acute Kidney Injury in Patients with Cirrhosis. New England Journal Of Medicine 2023, 388: 733-745. PMID: 36812435, DOI: 10.1056/nejmra2215289.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsAcute kidney injuryKidney injuryCommon conditionDiagnostic definitionPatientsInjuryCirrhosisPathophysiology
2022
Ascites and its complications
García‐Tsao G. Ascites and its complications. 2022, 2024-2043. DOI: 10.1002/9781119600206.ch98.Peer-Reviewed Original ResearchHepatic sinusoidal pressureHepatic venous pressure gradientSerum-ascites albumin gradientAcute kidney injuryPresence of ascitesVenous pressure gradientMain pathogenic mechanismPredominance of neutrophilsSinusoidal pressureAccumulation of fluidAbdominal ultrasonographyKidney injurySodium restrictionCirrhotic patientsPortal pressureSodium retentionDecompensated stageInflammatory processPolymorphonuclear cellsPeritoneal cavityAscites albuminAscitic fluidAscitesCirrhosisPathogenic mechanisms
2021
Admission Urinary and Serum Metabolites Predict Renal Outcomes in Hospitalized Patients With Cirrhosis
Bajaj JS, Garcia‐Tsao G, Reddy KR, O’Leary J, Vargas HE, Lai JC, Kamath PS, Tandon P, Subramanian RM, Thuluvath P, Fagan A, Sehrawat T, de la Rosa Rodriguez R, Thacker LR, Wong F. Admission Urinary and Serum Metabolites Predict Renal Outcomes in Hospitalized Patients With Cirrhosis. Hepatology 2021, 74: 2699-2713. PMID: 34002868, PMCID: PMC9338693, DOI: 10.1002/hep.31907.Peer-Reviewed Original ResearchConceptsAcute kidney injuryPrediction of AKIClinical variablesSerum/urineSerum metabolitesBranched-chain amino acid metabolitesLiver disease centerNorth American ConsortiumRole of serumAmino acid metabolitesAdmission urinaryAKI developmentAKI subgroupCirrhosis cohortRenal outcomesRenoprotective measuresKidney injuryAKI predictionCirrhosis severityDialysis initiationHospitalized patientsPoor prognosisUrine metabolomicsEarly initiationSpecific admission
2020
Acute Kidney Injury in Decompensated Cirrhosis Is Associated With Both Hypo‐coagulable and Hyper‐coagulable Features
Zanetto A, Rinder HM, Campello E, Saggiorato G, Deng Y, Ciarleglio M, Wilson FP, Senzolo M, Gavasso S, Bulato C, Simioni P, Garcia‐Tsao G. Acute Kidney Injury in Decompensated Cirrhosis Is Associated With Both Hypo‐coagulable and Hyper‐coagulable Features. Hepatology 2020, 72: 1327-1340. PMID: 32614088, PMCID: PMC8672302, DOI: 10.1002/hep.31443.Peer-Reviewed Original ResearchConceptsAcute kidney injuryPlasmin-antiplasmin complexDecompensated cirrhosisHemostasis assessmentVon Willebrand factorKidney injuryPlatelet functionThrombin generationPlatelet aggregationSeverity of cirrhosisMedian serum creatinineWillebrand factorLower platelet aggregationAnti-coagulant factorsImpaired platelet functionAKI resolutionHypercoagulable featuresSerum creatinineAspects of hemostasisCirrhosis patientsPlatelet countProspective studyFibrinolytic factorsCirrhosisHyperfibrinolytic stateAS044 Stage 1b acute kidney injury in cirrhosis is likely due to underlying chronic kidney disease and would be more appropriately re-classified as acute-on-chronic kidney disease
Wong F, Reddy R, Tandon P, O’Leary J, Biggins S, Garcia-Tsao G, Maliakkal B, Lai J, Fallon M, Vargas H, Subramanian R, Thuluvath P, Kamath P, Thacker L, Bajaj J. AS044 Stage 1b acute kidney injury in cirrhosis is likely due to underlying chronic kidney disease and would be more appropriately re-classified as acute-on-chronic kidney disease. Journal Of Hepatology 2020, 73: s35-s36. DOI: 10.1016/s0168-8278(20)30623-1.Peer-Reviewed Original ResearchAcute kidney injury is associated with reversible platelet dysfunction in hospitalized patients with decompensated cirrhosis
Zanetto A, Rinder H, Deng Y, Ciarleglio M, Wilson F, Bulato C, Simioni P, Garcia-Tsao G. Acute kidney injury is associated with reversible platelet dysfunction in hospitalized patients with decompensated cirrhosis. Digestive And Liver Disease 2020, 52: e13. DOI: 10.1016/j.dld.2019.12.031.Peer-Reviewed Original Research
2019
Impact of Chronic Kidney Disease on Outcomes in Cirrhosis
Wong F, Reddy K, O’Leary J, Tandon P, Biggins SW, Garcia‐Tsao G, Maliakkal BJ, Lai JC, Fallon MB, Vargas HE, Subramanian R, Thuluvath PJ, Kamath PS, Thacker L, Bajaj JS. Impact of Chronic Kidney Disease on Outcomes in Cirrhosis. Liver Transplantation 2019, 25: 870-880. PMID: 30908855, PMCID: PMC11075743, DOI: 10.1002/lt.25454.Peer-Reviewed Original ResearchConceptsChronic kidney diseaseKidney diseasePrevalence of CKDEnd-stage liver diseaseHospital clinical courseAcute kidney injuryChild-Pugh scoreChronic liver failureHigher serum creatinineGlomerular filtration rateHigh-risk groupNorth American ConsortiumCKD groupHospital courseKidney injuryRefractory ascitesNegative patientsOverall survivalPositive patientsSerum creatinineCirrhosis etiologyClinical courseHospital admissionHospitalized patientsLiver failureTu1519 – The Natural Histyory of Stages 2 & 3 Acute Kidney Injury (AKI) in Patients with Decompensated Cirrhosis and Ascites
Wong F, Reddy K, Tandon P, O'Leary J, Garcia-Tsao G, Lai J, Vargas H, Biggins S, Maliakkal B, Fallon M, Subramanian R, Thuluvath P, Kamath P, Thacker L, Bajaj J. Tu1519 – The Natural Histyory of Stages 2 & 3 Acute Kidney Injury (AKI) in Patients with Decompensated Cirrhosis and Ascites. Gastroenterology 2019, 156: s-1351. DOI: 10.1016/s0016-5085(19)40399-5.Peer-Reviewed Original ResearchSAT-140-The natural history of stages 2 and 3 acute kidney injury in hospitalized patients with decompensated cirrhosis and ascites
Wong F, Reddy R, Tandon P, O’leary J, Garcia-Tsao G, Lai J, Vargas H, Biggins S, Maliakkal B, Fallon M, Subramanian R, Thuluvath P, Kamath P, Thacker L, Bajaj J. SAT-140-The natural history of stages 2 and 3 acute kidney injury in hospitalized patients with decompensated cirrhosis and ascites. Journal Of Hepatology 2019, 70: e692. DOI: 10.1016/s0618-8278(19)31379-9.Peer-Reviewed Original ResearchOutcomes After Listing for Liver Transplant in Patients With Acute‐on‐Chronic Liver Failure: The Multicenter North American Consortium for the Study of End‐Stage Liver Disease Experience
O’Leary J, Bajaj JS, Tandon P, Biggins SW, Wong F, Kamath PS, Garcia‐Tsao G, Maliakkal B, Lai J, Fallon M, Vargas HE, Thuluvath P, Subramanian R, Thacker LR, Reddy K. Outcomes After Listing for Liver Transplant in Patients With Acute‐on‐Chronic Liver Failure: The Multicenter North American Consortium for the Study of End‐Stage Liver Disease Experience. Liver Transplantation 2019, 25: 571-579. PMID: 30724010, PMCID: PMC11075742, DOI: 10.1002/lt.25426.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAcute-On-Chronic Liver FailureAdultDisease ProgressionEnd Stage Liver DiseaseFemaleHospital MortalityHospitalizationHumansLiver CirrhosisLiver TransplantationMaleMiddle AgedNorth AmericaProspective StudiesRenal DialysisSeverity of Illness IndexSurvival RateTime-to-TreatmentWaiting ListsConceptsChronic liver failureLiver transplantationNorth American ConsortiumLiver failureEnd-stage liver disease (MELD) scoreEnd-stage liver diseaseAmerican ConsortiumExtrahepatic organ failureAcute kidney injuryLiver Disease scoreOutcomes of patientsPost-LT survivalPerioperative dialysisRenal recoveryKidney injuryLiver transplantOrgan failureLiver diseaseMedian timeMedian MELDACLFSimilar survivalDisease experienceDisease scorePatients
2018
Acute kidney injury, but not sepsis, is associated with higher procedure‐related bleeding in patients with decompensated cirrhosis
Hung A, Garcia‐Tsao G. Acute kidney injury, but not sepsis, is associated with higher procedure‐related bleeding in patients with decompensated cirrhosis. Liver International 2018, 38: 1437-1441. PMID: 29393567, PMCID: PMC6072624, DOI: 10.1111/liv.13712.Peer-Reviewed Original ResearchConceptsAcute kidney injuryProcedure-related bleedingKidney injuryPost-procedure bleedingRisk factorsCT scanEnd-stage renal diseaseInfection/sepsisAbnormal coagulation parametersBlood product transfusionLarge-volume paracentesisNon-cirrhotic patientsRetrospective chart reviewOnly independent predictorUnstratified cohortsMELD scoreProduct transfusionAdverse eventsChart reviewPatient characteristicsCirrhosis patientsIndependent predictorsRenal diseaseHemoglobin levelsCoagulation parameters
2017
Beta‐blockers in hospitalised patients with cirrhosis and ascites: mortality and factors determining discontinuation and reinitiation
Bhutta A, Garcia‐Tsao G, Reddy K, Tandon P, Wong F, O'Leary J, Acharya C, Banerjee D, Abraldes J, Jones T, Shaw J, Deng Y, Ciarleglio M, Bajaj J. Beta‐blockers in hospitalised patients with cirrhosis and ascites: mortality and factors determining discontinuation and reinitiation. Alimentary Pharmacology & Therapeutics 2017, 47: 78-85. PMID: 28994122, PMCID: PMC6016372, DOI: 10.1111/apt.14366.Peer-Reviewed Original ResearchConceptsMean arterial pressureBeta-blocker useLower mean arterial pressureBeta-blocker discontinuationRefractory ascitesHigh mortalityLower white blood cell countBeneficial anti-inflammatory effectsWhite blood cell countAcute kidney injuryAnti-inflammatory effectsTime of discontinuationBlood cell countEffect of BBBB discontinuationKidney injuryChart reviewHospital dischargeArterial pressureDiscontinuationAscitesCirrhosisPatientsCell countMortalityAcute Kidney Injury in Cirrhosis: Baseline Serum Creatinine Predicts Patient Outcomes
Wong F, O'Leary J, Reddy K, Garcia-Tsao G, Fallon M, Biggins S, Subramanian R, Thuluvath P, Kamath P, Patton H, Maliakkal B, Tandon P, Vargas H, Thacker L, Bajaj J. Acute Kidney Injury in Cirrhosis: Baseline Serum Creatinine Predicts Patient Outcomes. The American Journal Of Gastroenterology 2017, 112: 1103. PMID: 28440305, DOI: 10.1038/ajg.2017.122.Peer-Reviewed Original ResearchConceptsAcute kidney injuryBaseline serum creatinineHigher baseline serum creatinineInternational Ascites ClubSerum creatinineDelta serum creatinineAKI outcomesKidney injuryPatient outcomesDevelopment of AKIIncidence of AKIStage 1 acute kidney injuryTertiary-care hepatology centersEnd-stage liver diseaseBaseline SCr levelPeak serum creatinineMultivariate logistic regressionNorth American ConsortiumAKI episodesAKI progressionAKI riskCirrhotic inpatientsHepatology centersCirrhotic patientsSCr levels
2015
Ascites and Its Complications
Garcia‐Tsao G. Ascites and Its Complications. 2015, 2087-2106. DOI: 10.1002/9781118512074.ch106.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsAcute kidney injuryHepatorenal syndromeCompatible clinical presentationPostliver transplant outcomesCause of ascitesPancreatic ductal systemAccumulation of fluidKidney injuryTransplant outcomesTuberculous peritonitisHeart failureClinical presentationPancreatic ascitesDecompensated stageMalignant ascitesCirrhosisPeritoneal cavityAscitesBetter survivalDuctal systemPatientsPancreatic fluidOptimal managementComplicationsMain causeCorrigendum to “Diagnosis and management of acute kidney injury in patients with cirrhosis: Revised consensus recommendations of the International Club of Ascites” [J Hepatol 2015;62:968–974]
Angeli P, Ginès P, Wong F, Bernardi M, Boyer T, Gerbes A, Moreau R, Jalan R, Sarin S, Piano S, Moore K, Lee S, Durand F, Salerno F, Caraceni P, Kim W, Arroyo V, Garcia-Tsao G. Corrigendum to “Diagnosis and management of acute kidney injury in patients with cirrhosis: Revised consensus recommendations of the International Club of Ascites” [J Hepatol 2015;62:968–974]. Journal Of Hepatology 2015, 63: 290. DOI: 10.1016/j.jhep.2015.04.001.Commentaries, Editorials and Letters