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  1. Article ; Online: Editorial: Unmasking the silent threat-acute kidney injury in alcohol-associated hepatitis.

    Ma, Ann T / Patidar, Kavish R

    Alimentary pharmacology & therapeutics

    2023  Volume 59, Issue 1, Page(s) 122–123

    MeSH term(s) Humans ; Acute Kidney Injury/diagnosis ; Acute Kidney Injury/etiology ; Hepatitis, Alcoholic/diagnosis
    Language English
    Publishing date 2023-11-01
    Publishing country England
    Document type Editorial
    ZDB-ID 639012-2
    ISSN 1365-2036 ; 0269-2813 ; 0953-0673
    ISSN (online) 1365-2036
    ISSN 0269-2813 ; 0953-0673
    DOI 10.1111/apt.17771
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    Zs.A 2206: Show issues Location:
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  2. Article ; Online: Optimization of Kidney Health in Liver Transplant Candidates: Pretransplant Considerations and Modalities.

    Jan, Muhammad Y / Patidar, Kavish R / Ghabril, Marwan S / Kubal, Chandrashekhar A

    Transplantation

    2024  

    Abstract: Patients with decompensated end-stage liver disease (ESLD) are at increased risk for mortality, and only liver transplantation (LT) offers meaningful hope for survival. These patients are at risk for kidney dysfunction through the continuum of care for ... ...

    Abstract Patients with decompensated end-stage liver disease (ESLD) are at increased risk for mortality, and only liver transplantation (LT) offers meaningful hope for survival. These patients are at risk for kidney dysfunction through the continuum of care for ESLD including LT. We discuss the role of accurate estimation and measurement of baseline glomerular filtration rate in assessment of kidney dysfunction among those with ESLD. Optimizing kidney function is a vital goal in the management of these patients before LT. In this review, we summarize salient aspects of assessing and optimizing kidney function in this patient population. Precipitating factors and different causes of acute kidney injury are discussed, including hepatorenal syndrome. We further review treatment options for acute kidney injury including volume management. The role of vasopressor therapy, renal replacement therapy, and transjugular intrahepatic portosystemic shunting are discussed.
    Language English
    Publishing date 2024-01-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 208424-7
    ISSN 1534-6080 ; 0041-1337
    ISSN (online) 1534-6080
    ISSN 0041-1337
    DOI 10.1097/TP.0000000000004851
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    Zs.A 488: Show issues Location:
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  3. Article ; Online: From past to present to future: Terlipressin and hepatorenal syndrome-acute kidney injury.

    Allegretti, Andrew S / Patidar, Kavish R / Ma, Ann T / Cullaro, Giuseppe

    Hepatology (Baltimore, Md.)

    2024  

    Abstract: Hepatorenal syndrome (HRS) is a rare and highly morbid form of kidney injury unique to patients with decompensated cirrhosis. HRS is a physiologic consequence of portal hypertension, leading to a functional kidney injury that can be reversed by restoring ...

    Abstract Hepatorenal syndrome (HRS) is a rare and highly morbid form of kidney injury unique to patients with decompensated cirrhosis. HRS is a physiologic consequence of portal hypertension, leading to a functional kidney injury that can be reversed by restoring effective circulating volume and renal perfusion. While liver transplantation is the only definitive "cure" for HRS, medical management with vasoconstrictors and i.v. albumin is a cornerstone of supportive care. Terlipressin, a V1a receptor agonist that acts on the splanchnic circulation, has been used for many years outside the United States for the treatment of HRS. However, its recent Food and Drug Administration approval has generated new interest in this population, as a new base of prescribers now work to incorporate the drug into clinical practice. In this article, we review HRS pathophysiology and diagnostic criteria, the clinical use of terlipressin and alternative therapies, and identify areas of future research in the space of HRS and kidney injury in cirrhosis.
    Language English
    Publishing date 2024-02-14
    Publishing country United States
    Document type Journal Article
    ZDB-ID 604603-4
    ISSN 1527-3350 ; 0270-9139
    ISSN (online) 1527-3350
    ISSN 0270-9139
    DOI 10.1097/HEP.0000000000000790
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  4. Article ; Online: Recent Advances in the Management of Hepatorenal Syndrome: A US Perspective.

    Patidar, Kavish R / Piano, Salvatore / Cullaro, Giuseppe / Belcher, Justin M / Allegretti, Andrew S

    Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

    2023  Volume 21, Issue 4, Page(s) 897–901.e1

    MeSH term(s) Humans ; Hepatorenal Syndrome/diagnosis ; Hepatorenal Syndrome/therapy ; Liver Cirrhosis
    Language English
    Publishing date 2023-02-18
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
    ZDB-ID 2119789-1
    ISSN 1542-7714 ; 1542-3565
    ISSN (online) 1542-7714
    ISSN 1542-3565
    DOI 10.1016/j.cgh.2022.12.034
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    Zs.A 5836: Show issues Location:
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  5. Article ; Online: The association between mean arterial pressure and acute kidney injury reversal among patients with decompensated cirrhosis.

    Cullaro, Giuseppe / Allegretti, Andrew S / Fenton, Cynthia / Ge, Jin / Patidar, Kavish R / Rubin, Jessica / Sharma, Arjun / Lai, Jennifer C

    Hepatology (Baltimore, Md.)

    2024  

    Abstract: Background and aims: This study informs how mean arterial pressure (MAP) impacts acute kidney injury (AKI) recovery among all patients hospitalized with cirrhosis, regardless of etiology.: Approach and results: We identified incident AKI episodes ... ...

    Abstract Background and aims: This study informs how mean arterial pressure (MAP) impacts acute kidney injury (AKI) recovery among all patients hospitalized with cirrhosis, regardless of etiology.
    Approach and results: We identified incident AKI episodes among subjects in our cohort of patients with decompensated cirrhosis. AKI was defined as a ≥50% increase in creatinine from an outpatient baseline (≥7 days prior) that required hospitalization. Linear mixed effects models were completed to determine the impact between AKI recovery, MAP, and time. To determine the impact of MAP on AKI reversal, we completed time-dependent Cox regression models with time beginning at the time of peak creatinine and ending at death, discharge, or AKI reversal, among those hospitalized with AKI and those with persistent AKI (≥48 h) We identified 702 hospitalized patients with cirrhosis with AKI. We found those with AKI reversal had, on average, higher MAP (2.1 mm Hg, p <0.05) and a greater increase in MAP over time (0.1 mm Hg per hour, p <0.001). Among all 702 hospitalized patients with AKI and adjusted for confounders, each 5 mm Hg increase in MAP was associated with 1.07× the hazard of AKI reversal ( p <0.01). Similarly, among those with persistent AKI after adjusting for confounders, each 5 mm Hg increase in MAP was associated with a 1.19× greater likelihood of AKI reversal ( p <0.001).
    Discussion: Our data demonstrate that MAP significantly increases the likelihood of AKI recovery regardless of severity or injury or AKI phenotype. We believe these data highlight the importance of MAP as a clinical tool to promote kidney function recovery among patients with cirrhosis hospitalized with AKI.
    Language English
    Publishing date 2024-03-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 604603-4
    ISSN 1527-3350 ; 0270-9139
    ISSN (online) 1527-3350
    ISSN 0270-9139
    DOI 10.1097/HEP.0000000000000858
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    Zs.A 1660: Show issues Location:
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  6. Article ; Online: Defining an approach for therapeutic strategies in metabolic dysfunction-associated steatotic liver disease after liver transplantation.

    Siddiqui, Mohammad Shadab / Muthiah, Mark / Satapathy, Sanjaya K / Patidar, Kavish R / Bhat, Mamatha / Brandman, Danielle / Watt, Kymberly D / Rinella, Mary

    Hepatology (Baltimore, Md.)

    2023  

    Abstract: Occurrence of metabolic dysfunction-associated steatotic liver disease (MASLD) is common following liver transplantation (LT). MASLD can be classified as a recurrent disease when it occurs in patients receiving LT for metabolic dysfunction-associated ... ...

    Abstract Occurrence of metabolic dysfunction-associated steatotic liver disease (MASLD) is common following liver transplantation (LT). MASLD can be classified as a recurrent disease when it occurs in patients receiving LT for metabolic dysfunction-associated steatohepatitis (MASH) or as de novo when it occurs in patients undergoing transplantation for non-metabolic dysfunction-associated steatohepatitis etiologies of liver disease. Fibrosis progression in patients with MASLD is accelerated, with progression to cirrhosis occurring more rapidly compared with the general (ie, non-LT) population. Moreover, the metabolic burden in LT recipients with MASLD is high and synergizes with liver disease to negatively affect the clinical course. Despite the oversized clinical burden of MASLD among LT recipients, there is currently a lack of regulatory approach and pathway for therapeutics development in this patient population. The present document, thus, provides guidance for therapeutics development that incorporates nuances of transplant care in patients with post-LT MASLD to facilitate drug development.
    Language English
    Publishing date 2023-12-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 604603-4
    ISSN 1527-3350 ; 0270-9139
    ISSN (online) 1527-3350
    ISSN 0270-9139
    DOI 10.1097/HEP.0000000000000720
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    Zs.A 1660: Show issues Location:
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  7. Article ; Online: Controversies in terlipressin and transplantation in the United States: How do we MELD the two?

    Przybyszewski, Eric M / Wilechansky, Robert M / McLean Diaz, Paige / Allegretti, Andrew S / VanWagner, Lisa B / Cullaro, Giuseppe / Levitsky, Josh / Ginès, Pere / Piano, Salvatore / Asrani, Sumeet K / Patidar, Kavish R

    Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society

    2024  

    Abstract: Hepatorenal syndrome-acute kidney injury (HRS-AKI) is a severe complication of cirrhosis that carries a poor prognosis. The recent Food and Drug Administration approval of terlipressin has substantial implications for managing HRS-AKI and liver ... ...

    Abstract Hepatorenal syndrome-acute kidney injury (HRS-AKI) is a severe complication of cirrhosis that carries a poor prognosis. The recent Food and Drug Administration approval of terlipressin has substantial implications for managing HRS-AKI and liver allocation in the United States. Terlipressin has been available in Europe for over a decade, and several countries have adapted policy changes such as Model for End-Stage Liver Disease (MELD) score "lock" for HRS-AKI. In this article, we outline the European experience with terlipressin use and explore the question of whether terlipressin treatment for HRS-AKI should qualify for the MELD score "lock" in the United States in those who respond to therapy. Arguments for the MELD lock include protecting waitlist priority for terlipressin responders or partial responders who may miss offers due to MELD reduction in the terlipressin treatment window. Arguments against MELD lock include the fact that terlipressin may produce a durable response and improve overall survival and that equitable access to terlipressin is not guaranteed due to cost and availability. We subsequently discuss the proposed next steps for studying terlipressin implementation in the United States. A successful approach will require the involvement of all major stakeholders and the mobilization of our transplant community to spearhead research in this area.
    Language English
    Publishing date 2024-03-28
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2006866-9
    ISSN 1527-6473 ; 1527-6465
    ISSN (online) 1527-6473
    ISSN 1527-6465
    DOI 10.1097/LVT.0000000000000370
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  8. Article: Transjugular intrahepatic portosystemic shunt for refractory ascites in patients with high model for end-stage liver disease scores.

    Patidar, Kavish R / Sanyal, Arun J

    Clinical liver disease

    2016  Volume 7, Issue 4, Page(s) 84–87

    Language English
    Publishing date 2016-04-27
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2657644-2
    ISSN 2046-2484
    ISSN 2046-2484
    DOI 10.1002/cld.542
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  9. Article ; Online: Tired of Hepatitis B?

    Patidar, Kavish R / Bajaj, Jasmohan S

    Digestive diseases and sciences

    2016  Volume 61, Issue 4, Page(s) 953–954

    MeSH term(s) Adaptation, Psychological ; Fatigue ; Hepatitis B ; Humans
    Language English
    Publishing date 2016-04
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 304250-9
    ISSN 1573-2568 ; 0163-2116
    ISSN (online) 1573-2568
    ISSN 0163-2116
    DOI 10.1007/s10620-016-4067-8
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  10. Article ; Online: Social determinants of health impact mortality from HCC and cholangiocarcinoma: a population-based cohort study.

    Nephew, Lauren D / Gupta, Dipika / Carter, Allie / Desai, Archita P / Ghabril, Marwan / Patidar, Kavish R / Orman, Eric / Dziarski, Alisha / Chalasani, Naga

    Hepatology communications

    2023  Volume 7, Issue 3, Page(s) e0058

    Abstract: Background and aims: The social determinants of health can pose barriers to accessing cancer screening and treatment and have been associated with cancer mortality. However, it is not clear whether area deprivation is independently associated with ... ...

    Abstract Background and aims: The social determinants of health can pose barriers to accessing cancer screening and treatment and have been associated with cancer mortality. However, it is not clear whether area deprivation is independently associated with mortality in HCC and cholangiocarcinoma when controlling for individual-level social determinants of health.
    Approach and results: The cohort included individuals over 18 years old diagnosed with HCC (N=3460) or cholangiocarcinoma (N=781) and reported to the Indiana State Cancer Registry from 2009 to 2017. Area disadvantage was measured using the social deprivation index (SDI). SDI was obtained by linking addresses to the American Community Survey. Individual social determinants of health included race, ethnicity, sex, marital status, and insurance type. The primary outcome was mortality while controlling for SDI and individual social determinants of health by means of Cox proportional hazard modeling. In HCC, living in a neighborhood in the fourth quartile of census-track SDI (most deprived) was associated with higher mortality (HR: 1.14, 95% CI, 1.003-1.30, p=0.04) than living in a first quartile SDI neighborhood. Being uninsured (HR: 1.64, 95% CI, 1.30-2.07, p<0.0001) and never being married (HR: 1.31, 95% CI, 1.15-1.48, p<0.0001) were also associated with mortality in HCC. In cholangiocarcinoma, SDI was not associated with mortality.
    Conclusions: Social deprivation was independently associated with mortality in HCC but not cholangiocarcinoma. Further research is needed to better understand how to intervene on both area and individual social determinants of health and develop interventions to address these disparities.
    MeSH term(s) Humans ; Adolescent ; Cohort Studies ; Carcinoma, Hepatocellular ; Social Determinants of Health ; Liver Neoplasms ; Ethnicity
    Language English
    Publishing date 2023-02-09
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ISSN 2471-254X
    ISSN (online) 2471-254X
    DOI 10.1097/HC9.0000000000000058
    Database MEDical Literature Analysis and Retrieval System OnLINE

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