ABSTRACT
Breath tests for the evaluation liver metabolic function are a non-invasive diagnostic method with high sensitivity and specificity. Up today, the issue of liver damage in patients with chronic kidney disease has not been investigated sufficiently, although it might have significant clinical consequences. The following article describes the principles of breath tests, experiences with breath tests in patients with chronic kidney disease (CKD) and the results of our pilot study with methacetin breath tests in patients with CKD and in regular peritoneal dialysis treatment.
Subject(s)
Breath Tests , Renal Insufficiency, Chronic , Humans , Liver/pathology , Liver Cirrhosis , Liver Function Tests , Pilot Projects , Renal Insufficiency, Chronic/diagnosisABSTRACT
Hepatorenal syndrome (HRS) is a serious complication in patients with advanced liver cirrhosis and ascites occurring simultaneously. According to current diagnostic criteria it is considered as one of the less common forms of acute kidney injury (AKI), referred to as HRS-AKI. As a result of the revision of the diagnostic criteria, there was a significant shift in the diagnosis of AKI in patients with liver cirrhosis, allowing early initiation of adequate measures and appropriate treatment. The following article describes the issue of AKI in liver cirrhosis in a wider context, the diagnostic criteria and algorithm of HRS-AKI treatment.
Subject(s)
Acute Kidney Injury , Hepatorenal Syndrome , Liver Transplantation , Acute Kidney Injury/diagnosis , Acute Kidney Injury/etiology , Ascites , Hepatorenal Syndrome/diagnosis , Hepatorenal Syndrome/etiology , Hepatorenal Syndrome/therapy , Humans , Liver Cirrhosis/complicationsABSTRACT
Transient elastography, an examination based on the liver stiffness measurement, is a method validated for the non-invasive liver fibrosis staging. This method was recently successfully introduced into routine clinical practice. In accordance with the global- wide screening of viral hepatitis (chronic viral hepatitis type B and type C) and with the increasing effectiveness of antiviral therapy, as well as with the increasing prevalence of non-alcoholic fatty liver disease (NAFLD), the part of population requiring the care of hepatologists is certain to increase. Now more than ever we need a non-invasive, fast, safe, inexpensive and reliable method for evaluating patients with chronic liver disease. A new area of ââuse of elastography appears to be used to measure the stiffness of the spleen as a prediction of the presence of esophageal varices or the stiffness (or rather fibrosis) of transplanted kidneys. The aim of this review is to provide a comprehensive view of transient elastography, its principles, advantages and pitfalls, including its use in everyday clinical practice. Key words: cirrhosis - fibrosis - renal allograft - transient elastography.
