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Hepatic vein pressure predicts GFR in cirrhotic patients with hemodynamic kidney dysfunction
The role of “nephrocongestion” in hemodynamic renal disease is understudied. Intra‐abdominal hypertension accompanies liver disease and renal disease. Our hypothesis states that in those patients with liver disease, hepatic vein pressure measured during a transjugular intrahepatic portosystemic shun...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5471440/ https://www.ncbi.nlm.nih.gov/pubmed/28611152 http://dx.doi.org/10.14814/phy2.13301 |
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author | Desai, Neel Neugarten, Joel Dominguez, Mary Golestaneh, Ladan |
author_facet | Desai, Neel Neugarten, Joel Dominguez, Mary Golestaneh, Ladan |
author_sort | Desai, Neel |
collection | PubMed |
description | The role of “nephrocongestion” in hemodynamic renal disease is understudied. Intra‐abdominal hypertension accompanies liver disease and renal disease. Our hypothesis states that in those patients with liver disease, hepatic vein pressure measured during a transjugular intrahepatic portosystemic shunt (TIPS) procedure reflects intra‐abdominal pressure and predicts estimated glomerular filtration rate (eGFR). We gathered data from our clinical database and chart review on a cohort of cirrhotic patients who received TIPS at Montefiore as part of their clinical care between 2004 and 2014. We evaluated association of demographic and measured variables with eGFR in those subjects without end‐stage renal disease (ESRD). Using multivariate regression, we examined the relationship between eGFR and hepatic vein pressure while adjusting for age, proteinuria, and ultrasound evidence for parenchymal kidney disease. The mean age of the subjects was 57 years old. Two thirds of the patients were male, 23% were White, and 20% were Black. A higher percentage of patients with chronic kidney disease (CKD), as determined by lower than 60 mL/min/1.73 m(2), had proteinuria and ultrasound evidence for parenchymal kidney disease. A multivariate linear regression showed a significant and negative association between hepatic vein pressure and eGFR when adjusting for age, race, and proteinuria. Hepatic vein pressure is negatively and significantly associated with eGFR in those patients with liver failure. This finding has major implications for the way we evaluate hemodynamic renal disease. |
format | Online Article Text |
id | pubmed-5471440 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-54714402017-06-21 Hepatic vein pressure predicts GFR in cirrhotic patients with hemodynamic kidney dysfunction Desai, Neel Neugarten, Joel Dominguez, Mary Golestaneh, Ladan Physiol Rep Original Research The role of “nephrocongestion” in hemodynamic renal disease is understudied. Intra‐abdominal hypertension accompanies liver disease and renal disease. Our hypothesis states that in those patients with liver disease, hepatic vein pressure measured during a transjugular intrahepatic portosystemic shunt (TIPS) procedure reflects intra‐abdominal pressure and predicts estimated glomerular filtration rate (eGFR). We gathered data from our clinical database and chart review on a cohort of cirrhotic patients who received TIPS at Montefiore as part of their clinical care between 2004 and 2014. We evaluated association of demographic and measured variables with eGFR in those subjects without end‐stage renal disease (ESRD). Using multivariate regression, we examined the relationship between eGFR and hepatic vein pressure while adjusting for age, proteinuria, and ultrasound evidence for parenchymal kidney disease. The mean age of the subjects was 57 years old. Two thirds of the patients were male, 23% were White, and 20% were Black. A higher percentage of patients with chronic kidney disease (CKD), as determined by lower than 60 mL/min/1.73 m(2), had proteinuria and ultrasound evidence for parenchymal kidney disease. A multivariate linear regression showed a significant and negative association between hepatic vein pressure and eGFR when adjusting for age, race, and proteinuria. Hepatic vein pressure is negatively and significantly associated with eGFR in those patients with liver failure. This finding has major implications for the way we evaluate hemodynamic renal disease. John Wiley and Sons Inc. 2017-06-14 /pmc/articles/PMC5471440/ /pubmed/28611152 http://dx.doi.org/10.14814/phy2.13301 Text en © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society. This is an open access article under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Research Desai, Neel Neugarten, Joel Dominguez, Mary Golestaneh, Ladan Hepatic vein pressure predicts GFR in cirrhotic patients with hemodynamic kidney dysfunction |
title | Hepatic vein pressure predicts GFR in cirrhotic patients with hemodynamic kidney dysfunction |
title_full | Hepatic vein pressure predicts GFR in cirrhotic patients with hemodynamic kidney dysfunction |
title_fullStr | Hepatic vein pressure predicts GFR in cirrhotic patients with hemodynamic kidney dysfunction |
title_full_unstemmed | Hepatic vein pressure predicts GFR in cirrhotic patients with hemodynamic kidney dysfunction |
title_short | Hepatic vein pressure predicts GFR in cirrhotic patients with hemodynamic kidney dysfunction |
title_sort | hepatic vein pressure predicts gfr in cirrhotic patients with hemodynamic kidney dysfunction |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5471440/ https://www.ncbi.nlm.nih.gov/pubmed/28611152 http://dx.doi.org/10.14814/phy2.13301 |
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