Liver transplantation: current indications and patient selection for adult patients with chronic liver disease.

Liver transplantation is a life saving procedure for patients with a variety of irreversible acute and chronic liver diseases for which no other therapy is available. To date, success of transplantation has been significantly improved with 1-year graft and patient survival rates of approximately 90%. As new information becomes available the indications for individual diseases have been changed somewhat. This review will provide a general basis for patient selection and timing of liver transplantation for adult patients with chronic liver disease.

Prevalence of chronic kidney disease in Thai adult population.

OBJECTIVE: Chronic kidney disease (CKD) is a major public health problem worldwide. Until now, no large-scale data about the prevalence of pre-dialysis CKD has been reported in Thailand. MATERIAL AND METHOD: The clinical and laboratory data from the ground air force personnel who were routinely checked up during 2002-2003 were collected and descriptively analyzed. The pilots and air crews were excluded. All personnel were working in Bangkok. RESULTS: 15,612 RTAF personnel completed the annual check up. Eighty-two percent were male. The average age was 45.7 +/- 8 (19-65) years. According to the classification of stages of CKD by Kidney Disease Outcome Quality Initiative (K/DOQI), the prevalence of CKD is 9.1% by Cockcroft Gault formula and 4.6% by Modification of Diet in Renal Disease. Patients with diabetes mellitus, hypertension, hypercholesterolemia and proteinuria were found in 8.2%, 45.8 %, 28.2 % and 1.8% respectively. CKD patients were older had higher body weight, Body Mass Index (BMI), blood pressure and blood sugar than non CKD personnel. CONCLUSION: CKD were not uncommon among RTAF personnel. The Cockcroft-Gault and MDRD equations were different in detecting CKD in the present study. The appropriate equation to determine GFR in Thai population should be evaluated. Low sensitivity of dipstick proteinuria may cause the low prevalence of stage 1 and 2 CKD.