Acute kidney injury in patients with cirrhosis: perils and promise.
Acute kidney injury in patients with cirrhosis: perils and promise.
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DOI：
10.1016/j.cgh.2013.03.018
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发表时间：
2013-12
影响因子：
12.6
通讯作者：
Garcia-Tsao, Guadalupe
中科院分区：
文献类型：
--
作者：
Belcher, Justin M.;Parikh, Chirag R.;Garcia-Tsao, Guadalupe
62岁男性丙型肝炎并发肝硬化，慢性酒精滥用，因呕血和精神状态改变住进重症监护病房。体格检查显示慢性肝病的腹水和红斑。血压为87/42毫米汞柱，而实验室研究显示血清肌酐水平为0.8 mg/dL，肾小球滤过率（GFR）估计为84 ml/min/1.73 m2，使用肾脏疾病饮食修正（MDRD）研究方程计算，血清钠123 mEq/L，血清总胆红素4.3 mg/dL，国际正常化比率（INR） 1.6。病人被灌注红细胞和新鲜冷冻血浆复苏，出血得到控制。然而，在入院的第三天，肌酐上升到1.5 mg/dL。尿液沉淀物检查显示每高倍镜可见1-5个胆红素染色的颗粒样物和少量肾小管上皮细胞。尿钠21 mEq/L，钠的分数排泄（FENa）为0.43%。
A 62-year-old man with cirrhosis secondary to hepatitis C and chronic alcohol abuse is admitted to the intensive care unit with hematemesis and mental status changes. Physical examination reveals ascites and stigmata of chronic liver disease. Blood pressure is noted as 87/42 mm Hg while laboratory studies show serum creatinine level of 0.8 mg/dL, estimated glomerular filtration rate (GFR) 84 ml/min/1.73 m2 calculated using the Modification of Diet in Renal Disease (MDRD) Study equation, serum sodium 123 mEq/L, total serum bilirubin 4.3 mg/dL and international normalization ratio (INR) 1.6. The patient is resuscitated with packed red blood cells and fresh frozen plasma and bleeding is controlled. However, on the third day of admission, creatinine rises to 1.5 mg/dL. Examination of urine sediment reveals 1–5 bilirubin stained granular casts per high powered field and a few renal tubular epithelial cells. Urine sodium is 21 mEq/L and fractional excretion of sodium (FENa) is 0.43%.
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影响因子：
13.5
作者：
Belcher, Justin M.;Garcia-Tsao, Guadalupe;Sanyal, Arun J.;Bhogal, Harjit;Lim, Joseph K.;Ansari, Naheed;Coca, Steven G.;Parikh, Chirag R.
通讯作者：
Parikh, Chirag R.
影响因子：
4.3
作者：
Chen, Yu-Wei;Chen, Han-Hsiang;Wu, Chih-Jen
通讯作者：
Wu, Chih-Jen
影响因子：
29.4
作者：
Gines, A;FernandezEsparrach, G;Rodes, J
通讯作者：
Rodes, J
影响因子：
13.5
作者：
Cárdenas, A;Ginès, P;Rodes, J
通讯作者：
Rodes, J
影响因子：
6
作者：
Aghel, Arash;Shrestha, Kevin;Mullens, Wilfried;Borowski, Allen;Tang, W. H. Wilson
通讯作者：
Tang, W. H. Wilson