Multiparametric renal function assessment in cirrhotic patients shows high prevalence of medically actionable changes in multiple modules
Aim Renal dysfunction is a common complication of cirrhosis, occurring either as part of multiorgan involvement in acute illness or secondary to advanced liver disease. To date, no study has comprehensively assessed multiple renal function parameters in hospitalized patients with cirrhosis through a...
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| Veröffentlicht in: | Hepatology research 2024-11, Vol.54 (11), p.1035-1048 |
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| creator | Belmonte, Richard Silva‐Rodriguez, Maël Barbé, Françoise Bensenane, Mouni Haghenejad, Vincent Vrillon, Isabelle Alla, Asma Flahault, Adrien Kormann, Raphael Corbel, Alice Aitdjafer, Zakia Quilliot, Didier Derain‐Dubourg, Laurence Namour, Farès Guéant, Jean‐Louis Bronowicki, Jean‐Pierre Oussalah, Abderrahim |
| description | Aim
Renal dysfunction is a common complication of cirrhosis, occurring either as part of multiorgan involvement in acute illness or secondary to advanced liver disease. To date, no study has comprehensively assessed multiple renal function parameters in hospitalized patients with cirrhosis through a multiparametric analysis of renal biochemistry markers.
Methods
We conducted a retrospective, observational study including all consecutive patients hospitalized with cirrhosis who underwent a 43‐multiparametric renal function assessment between January 1, 2021, and June 30, 2023.
Results
All patients showed at least one of the following renal abnormalities: Kidney Disease: Improving Global Outcomes stage G2 or higher, sodium and/or chloride excretion fraction |
| doi_str_mv | 10.1111/hepr.14050 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3046517102</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3046517102</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3520-a92c5d9ed5df73e7174c9cf8777c7c77598a947385d70046ff002d352bdf221d3</originalsourceid><addsrcrecordid>eNp9kc1q3DAUhUVoyc80mzxAEXRTAk71Y1v2soS0CaS0lBa6MxrpKlaQLVeyG-YR-ta9M5NkkUUlkMThu0dwDiFnnF1wXB96mNIFL1nFDsgxb5QomCx_vcK3bOqilmV9RE5yvmeMKybKQ3KEei2kbI7J3y9LmP2kkx5gTt7QBKMO1C2jmX0cqc4Zch5gnKkfqfEp9XFGbNKzRzHT3MeHTHt_19MpwR8dYDRAo6MDWG90CBuqd1Z6HYCaXo93kLdew-5j1IZolwD5DXntdMhw-nivyM9PVz8ur4vbr59vLj_eFkZWghW6FaayLdjKOiVBcVWa1rhGKWVwq6ptdFsq2VRWMVbWzjEmLI6urROCW7ki7_e-U4q_F8hzN_hsIAQ9QlxyJ3Go4oozgei7F-h9XBLmgxTH_Col8VyR8z1lUsw5geum5AedNh1n3bagbltQtysI4bePlssaE3pGnxpBgO-BBx9g8x-r7vrq2_e96T-TBZ3B</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3123357323</pqid></control><display><type>article</type><title>Multiparametric renal function assessment in cirrhotic patients shows high prevalence of medically actionable changes in multiple modules</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Belmonte, Richard ; Silva‐Rodriguez, Maël ; Barbé, Françoise ; Bensenane, Mouni ; Haghenejad, Vincent ; Vrillon, Isabelle ; Alla, Asma ; Flahault, Adrien ; Kormann, Raphael ; Corbel, Alice ; Aitdjafer, Zakia ; Quilliot, Didier ; Derain‐Dubourg, Laurence ; Namour, Farès ; Guéant, Jean‐Louis ; Bronowicki, Jean‐Pierre ; Oussalah, Abderrahim</creator><creatorcontrib>Belmonte, Richard ; Silva‐Rodriguez, Maël ; Barbé, Françoise ; Bensenane, Mouni ; Haghenejad, Vincent ; Vrillon, Isabelle ; Alla, Asma ; Flahault, Adrien ; Kormann, Raphael ; Corbel, Alice ; Aitdjafer, Zakia ; Quilliot, Didier ; Derain‐Dubourg, Laurence ; Namour, Farès ; Guéant, Jean‐Louis ; Bronowicki, Jean‐Pierre ; Oussalah, Abderrahim</creatorcontrib><description>Aim
Renal dysfunction is a common complication of cirrhosis, occurring either as part of multiorgan involvement in acute illness or secondary to advanced liver disease. To date, no study has comprehensively assessed multiple renal function parameters in hospitalized patients with cirrhosis through a multiparametric analysis of renal biochemistry markers.
Methods
We conducted a retrospective, observational study including all consecutive patients hospitalized with cirrhosis who underwent a 43‐multiparametric renal function assessment between January 1, 2021, and June 30, 2023.
Results
All patients showed at least one of the following renal abnormalities: Kidney Disease: Improving Global Outcomes stage G2 or higher, sodium and/or chloride excretion fraction <1%, electrolyte‐free water clearance <0.4 mL/min, or tubular maximum phosphate reabsorption capacity <0.8 mmol/L. The estimated glomerular filtration rate equations significantly overestimated the measured creatinine clearance with median differences of +14 mL/min/1.73 m2 (95% CI 6–29) and +9 mL/min/1.73 m2 (95% CI 2–15) for European Kidney Function Consortium equations, respectively. Notably, 54% and 39% of patients demonstrated estimated glomerular filtration rates exceeding 30% of the measured creatinine clearance when the Chronic Kidney Disease ‐ Epidemiology Collaboration and European Kidney Function Consortium formulas were employed, respectively. Substantial discrepancies in Kidney Disease: Improving Global Outcomes stage assignments were observed between the estimated glomerular filtration rate‐ and measured creatinine clearance‐based assessments.
Conclusions
This study underscores the value of a multiparametric renal function assessment as a routine tool for evaluating renal function in patients with cirrhosis. A high prevalence of medically actionable renal abnormalities spanning multiple renal function modules, including alterations in glomerular function, salt and solute‐free water excretion, and proximal tubule phosphate reabsorption, has been demonstrated in hospitalized patients with cirrhosis.
Our study highlights the effectiveness of multiparametric renal function assessment in patients with cirrhosis, revealing widespread clinically significant renal abnormalities and the inadequacy of standard estimated glomerular filtration rate formulas, underscoring the need for more accurate assessments to improve patient care.</description><identifier>ISSN: 1386-6346</identifier><identifier>EISSN: 1872-034X</identifier><identifier>DOI: 10.1111/hepr.14050</identifier><identifier>PMID: 38662338</identifier><language>eng</language><publisher>Netherlands: Wiley Subscription Services, Inc</publisher><subject>Cirrhosis ; Creatinine ; Epidemiology ; estimated glomerular filtration rate ; Excretion ; Glomerular filtration rate ; glomerular function ; Hospitalization ; Kidney diseases ; Liver cirrhosis ; Liver diseases ; multiparametric renal function assessment ; proximal tubulopathy ; Reabsorption ; Renal function ; tubular reabsorption of phosphate</subject><ispartof>Hepatology research, 2024-11, Vol.54 (11), p.1035-1048</ispartof><rights>2024 The Authors. Hepatology Research published by John Wiley & Sons Australia, Ltd on behalf of Japan Society of Hepatology.</rights><rights>2024. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3520-a92c5d9ed5df73e7174c9cf8777c7c77598a947385d70046ff002d352bdf221d3</cites><orcidid>0009-0007-6191-7452 ; 0000-0002-9731-4529</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fhepr.14050$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fhepr.14050$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38662338$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Belmonte, Richard</creatorcontrib><creatorcontrib>Silva‐Rodriguez, Maël</creatorcontrib><creatorcontrib>Barbé, Françoise</creatorcontrib><creatorcontrib>Bensenane, Mouni</creatorcontrib><creatorcontrib>Haghenejad, Vincent</creatorcontrib><creatorcontrib>Vrillon, Isabelle</creatorcontrib><creatorcontrib>Alla, Asma</creatorcontrib><creatorcontrib>Flahault, Adrien</creatorcontrib><creatorcontrib>Kormann, Raphael</creatorcontrib><creatorcontrib>Corbel, Alice</creatorcontrib><creatorcontrib>Aitdjafer, Zakia</creatorcontrib><creatorcontrib>Quilliot, Didier</creatorcontrib><creatorcontrib>Derain‐Dubourg, Laurence</creatorcontrib><creatorcontrib>Namour, Farès</creatorcontrib><creatorcontrib>Guéant, Jean‐Louis</creatorcontrib><creatorcontrib>Bronowicki, Jean‐Pierre</creatorcontrib><creatorcontrib>Oussalah, Abderrahim</creatorcontrib><title>Multiparametric renal function assessment in cirrhotic patients shows high prevalence of medically actionable changes in multiple modules</title><title>Hepatology research</title><addtitle>Hepatol Res</addtitle><description>Aim
Renal dysfunction is a common complication of cirrhosis, occurring either as part of multiorgan involvement in acute illness or secondary to advanced liver disease. To date, no study has comprehensively assessed multiple renal function parameters in hospitalized patients with cirrhosis through a multiparametric analysis of renal biochemistry markers.
Methods
We conducted a retrospective, observational study including all consecutive patients hospitalized with cirrhosis who underwent a 43‐multiparametric renal function assessment between January 1, 2021, and June 30, 2023.
Results
All patients showed at least one of the following renal abnormalities: Kidney Disease: Improving Global Outcomes stage G2 or higher, sodium and/or chloride excretion fraction <1%, electrolyte‐free water clearance <0.4 mL/min, or tubular maximum phosphate reabsorption capacity <0.8 mmol/L. The estimated glomerular filtration rate equations significantly overestimated the measured creatinine clearance with median differences of +14 mL/min/1.73 m2 (95% CI 6–29) and +9 mL/min/1.73 m2 (95% CI 2–15) for European Kidney Function Consortium equations, respectively. Notably, 54% and 39% of patients demonstrated estimated glomerular filtration rates exceeding 30% of the measured creatinine clearance when the Chronic Kidney Disease ‐ Epidemiology Collaboration and European Kidney Function Consortium formulas were employed, respectively. Substantial discrepancies in Kidney Disease: Improving Global Outcomes stage assignments were observed between the estimated glomerular filtration rate‐ and measured creatinine clearance‐based assessments.
Conclusions
This study underscores the value of a multiparametric renal function assessment as a routine tool for evaluating renal function in patients with cirrhosis. A high prevalence of medically actionable renal abnormalities spanning multiple renal function modules, including alterations in glomerular function, salt and solute‐free water excretion, and proximal tubule phosphate reabsorption, has been demonstrated in hospitalized patients with cirrhosis.
Our study highlights the effectiveness of multiparametric renal function assessment in patients with cirrhosis, revealing widespread clinically significant renal abnormalities and the inadequacy of standard estimated glomerular filtration rate formulas, underscoring the need for more accurate assessments to improve patient care.</description><subject>Cirrhosis</subject><subject>Creatinine</subject><subject>Epidemiology</subject><subject>estimated glomerular filtration rate</subject><subject>Excretion</subject><subject>Glomerular filtration rate</subject><subject>glomerular function</subject><subject>Hospitalization</subject><subject>Kidney diseases</subject><subject>Liver cirrhosis</subject><subject>Liver diseases</subject><subject>multiparametric renal function assessment</subject><subject>proximal tubulopathy</subject><subject>Reabsorption</subject><subject>Renal function</subject><subject>tubular reabsorption of phosphate</subject><issn>1386-6346</issn><issn>1872-034X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><recordid>eNp9kc1q3DAUhUVoyc80mzxAEXRTAk71Y1v2soS0CaS0lBa6MxrpKlaQLVeyG-YR-ta9M5NkkUUlkMThu0dwDiFnnF1wXB96mNIFL1nFDsgxb5QomCx_vcK3bOqilmV9RE5yvmeMKybKQ3KEei2kbI7J3y9LmP2kkx5gTt7QBKMO1C2jmX0cqc4Zch5gnKkfqfEp9XFGbNKzRzHT3MeHTHt_19MpwR8dYDRAo6MDWG90CBuqd1Z6HYCaXo93kLdew-5j1IZolwD5DXntdMhw-nivyM9PVz8ur4vbr59vLj_eFkZWghW6FaayLdjKOiVBcVWa1rhGKWVwq6ptdFsq2VRWMVbWzjEmLI6urROCW7ki7_e-U4q_F8hzN_hsIAQ9QlxyJ3Go4oozgei7F-h9XBLmgxTH_Col8VyR8z1lUsw5geum5AedNh1n3bagbltQtysI4bePlssaE3pGnxpBgO-BBx9g8x-r7vrq2_e96T-TBZ3B</recordid><startdate>202411</startdate><enddate>202411</enddate><creator>Belmonte, Richard</creator><creator>Silva‐Rodriguez, Maël</creator><creator>Barbé, Françoise</creator><creator>Bensenane, Mouni</creator><creator>Haghenejad, Vincent</creator><creator>Vrillon, Isabelle</creator><creator>Alla, Asma</creator><creator>Flahault, Adrien</creator><creator>Kormann, Raphael</creator><creator>Corbel, Alice</creator><creator>Aitdjafer, Zakia</creator><creator>Quilliot, Didier</creator><creator>Derain‐Dubourg, Laurence</creator><creator>Namour, Farès</creator><creator>Guéant, Jean‐Louis</creator><creator>Bronowicki, Jean‐Pierre</creator><creator>Oussalah, Abderrahim</creator><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TM</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope><orcidid>https://orcid.org/0009-0007-6191-7452</orcidid><orcidid>https://orcid.org/0000-0002-9731-4529</orcidid></search><sort><creationdate>202411</creationdate><title>Multiparametric renal function assessment in cirrhotic patients shows high prevalence of medically actionable changes in multiple modules</title><author>Belmonte, Richard ; Silva‐Rodriguez, Maël ; Barbé, Françoise ; Bensenane, Mouni ; Haghenejad, Vincent ; Vrillon, Isabelle ; Alla, Asma ; Flahault, Adrien ; Kormann, Raphael ; Corbel, Alice ; Aitdjafer, Zakia ; Quilliot, Didier ; Derain‐Dubourg, Laurence ; Namour, Farès ; Guéant, Jean‐Louis ; Bronowicki, Jean‐Pierre ; Oussalah, Abderrahim</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3520-a92c5d9ed5df73e7174c9cf8777c7c77598a947385d70046ff002d352bdf221d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Cirrhosis</topic><topic>Creatinine</topic><topic>Epidemiology</topic><topic>estimated glomerular filtration rate</topic><topic>Excretion</topic><topic>Glomerular filtration rate</topic><topic>glomerular function</topic><topic>Hospitalization</topic><topic>Kidney diseases</topic><topic>Liver cirrhosis</topic><topic>Liver diseases</topic><topic>multiparametric renal function assessment</topic><topic>proximal tubulopathy</topic><topic>Reabsorption</topic><topic>Renal function</topic><topic>tubular reabsorption of phosphate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Belmonte, Richard</creatorcontrib><creatorcontrib>Silva‐Rodriguez, Maël</creatorcontrib><creatorcontrib>Barbé, Françoise</creatorcontrib><creatorcontrib>Bensenane, Mouni</creatorcontrib><creatorcontrib>Haghenejad, Vincent</creatorcontrib><creatorcontrib>Vrillon, Isabelle</creatorcontrib><creatorcontrib>Alla, Asma</creatorcontrib><creatorcontrib>Flahault, Adrien</creatorcontrib><creatorcontrib>Kormann, Raphael</creatorcontrib><creatorcontrib>Corbel, Alice</creatorcontrib><creatorcontrib>Aitdjafer, Zakia</creatorcontrib><creatorcontrib>Quilliot, Didier</creatorcontrib><creatorcontrib>Derain‐Dubourg, Laurence</creatorcontrib><creatorcontrib>Namour, Farès</creatorcontrib><creatorcontrib>Guéant, Jean‐Louis</creatorcontrib><creatorcontrib>Bronowicki, Jean‐Pierre</creatorcontrib><creatorcontrib>Oussalah, Abderrahim</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Hepatology research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Belmonte, Richard</au><au>Silva‐Rodriguez, Maël</au><au>Barbé, Françoise</au><au>Bensenane, Mouni</au><au>Haghenejad, Vincent</au><au>Vrillon, Isabelle</au><au>Alla, Asma</au><au>Flahault, Adrien</au><au>Kormann, Raphael</au><au>Corbel, Alice</au><au>Aitdjafer, Zakia</au><au>Quilliot, Didier</au><au>Derain‐Dubourg, Laurence</au><au>Namour, Farès</au><au>Guéant, Jean‐Louis</au><au>Bronowicki, Jean‐Pierre</au><au>Oussalah, Abderrahim</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multiparametric renal function assessment in cirrhotic patients shows high prevalence of medically actionable changes in multiple modules</atitle><jtitle>Hepatology research</jtitle><addtitle>Hepatol Res</addtitle><date>2024-11</date><risdate>2024</risdate><volume>54</volume><issue>11</issue><spage>1035</spage><epage>1048</epage><pages>1035-1048</pages><issn>1386-6346</issn><eissn>1872-034X</eissn><abstract>Aim
Renal dysfunction is a common complication of cirrhosis, occurring either as part of multiorgan involvement in acute illness or secondary to advanced liver disease. To date, no study has comprehensively assessed multiple renal function parameters in hospitalized patients with cirrhosis through a multiparametric analysis of renal biochemistry markers.
Methods
We conducted a retrospective, observational study including all consecutive patients hospitalized with cirrhosis who underwent a 43‐multiparametric renal function assessment between January 1, 2021, and June 30, 2023.
Results
All patients showed at least one of the following renal abnormalities: Kidney Disease: Improving Global Outcomes stage G2 or higher, sodium and/or chloride excretion fraction <1%, electrolyte‐free water clearance <0.4 mL/min, or tubular maximum phosphate reabsorption capacity <0.8 mmol/L. The estimated glomerular filtration rate equations significantly overestimated the measured creatinine clearance with median differences of +14 mL/min/1.73 m2 (95% CI 6–29) and +9 mL/min/1.73 m2 (95% CI 2–15) for European Kidney Function Consortium equations, respectively. Notably, 54% and 39% of patients demonstrated estimated glomerular filtration rates exceeding 30% of the measured creatinine clearance when the Chronic Kidney Disease ‐ Epidemiology Collaboration and European Kidney Function Consortium formulas were employed, respectively. Substantial discrepancies in Kidney Disease: Improving Global Outcomes stage assignments were observed between the estimated glomerular filtration rate‐ and measured creatinine clearance‐based assessments.
Conclusions
This study underscores the value of a multiparametric renal function assessment as a routine tool for evaluating renal function in patients with cirrhosis. A high prevalence of medically actionable renal abnormalities spanning multiple renal function modules, including alterations in glomerular function, salt and solute‐free water excretion, and proximal tubule phosphate reabsorption, has been demonstrated in hospitalized patients with cirrhosis.
Our study highlights the effectiveness of multiparametric renal function assessment in patients with cirrhosis, revealing widespread clinically significant renal abnormalities and the inadequacy of standard estimated glomerular filtration rate formulas, underscoring the need for more accurate assessments to improve patient care.</abstract><cop>Netherlands</cop><pub>Wiley Subscription Services, Inc</pub><pmid>38662338</pmid><doi>10.1111/hepr.14050</doi><tpages>14</tpages><orcidid>https://orcid.org/0009-0007-6191-7452</orcidid><orcidid>https://orcid.org/0000-0002-9731-4529</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Cirrhosis Creatinine Epidemiology estimated glomerular filtration rate Excretion Glomerular filtration rate glomerular function Hospitalization Kidney diseases Liver cirrhosis Liver diseases multiparametric renal function assessment proximal tubulopathy Reabsorption Renal function tubular reabsorption of phosphate |
| title | Multiparametric renal function assessment in cirrhotic patients shows high prevalence of medically actionable changes in multiple modules |
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