| Dialysis reduces portal pressure in patients with chronic hepatitis C. | |
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MedLine Citation:
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PMID: 20653650 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The purpose of this study was to characterize changes in hepatic venous pressures in patients with chronic hepatitis C. The histology and laboratory data from patients with chronic hepatitis C who underwent a transjugular liver biopsy (TJLB) and hepatic venous pressure gradient measurement were analyzed. Portal hypertension was defined as hepatic venous pressure gradient > or =6 mm Hg. A single pathologist masked to hepatic venous pressure gradient scored liver sections for inflammation and fibrosis. The patients with high-grade inflammation (relative risk [RR] 2.82, P = 0.027, multivariate analysis) and late-stage fibrosis (RR 2.81, P = 0.022) were more likely to have a hepatic venous pressure gradient > or =6 mm Hg, while the patients on dialysis (RR 0.32, P = 0.01) were less likely to have a hepatic venous pressure gradient > or =6 mm Hg. The patients on dialysis (n = 58) had an elevated serum blood urea nitrogen and creatinine when compared with those who were not (n = 75) (47.6 +/- 3.3 and 7.98 +/- 0.4 vs. 25.9 +/- 2.0 and 1.66 +/- 0.22 mg/dL, respectively; P < 0.001). While the hepatic venous pressure gradient increased with the rising levels of liver fibrosis in the latter group (P < 0.01), it did not change in the patients on dialysis (P = 0.41). The median hepatic venous pressure gradient was especially low in late-stage fibrosis patients on dialysis when compared with the latter group (5 vs. 10 mm Hg, P = 0.017). In patients on dialysis, serum transaminases were low across all levels of fibrosis. Twenty-three of the 92 patients with early fibrosis had a hepatic venous pressure gradient > or =6 mm Hg. In patients with chronic hepatitis C, concomitant TJLB and hepatic venous pressure gradient measurement identify those who have early fibrosis and portal hypertension. Long-term hemodialysis may reduce portal pressure in these patients. |
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Authors:
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Sandeep Khurana; Thomas Simcox; William Twaddell; Cinthia Drachenberg; Mark Flasar |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Artificial organs Volume: 34 ISSN: 1525-1594 ISO Abbreviation: Artif Organs Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-07-26 Completed Date: 2010-11-08 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7802778 Medline TA: Artif Organs Country: United States |
Other Details:
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Languages: eng Pagination: 570-9 Citation Subset: IM |
Affiliation:
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Division of Gastroenterology and Hepatology, VA Maryland Health Care System and University of Maryland School of Medicine, Baltimore, MD 21201, USA. skhurana@medicine.umaryland.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Hepatitis C, Chronic
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pathology,
physiopathology*,
therapy Humans Liver / pathology, physiopathology* Liver Cirrhosis / pathology, physiopathology Portal Pressure* Renal Dialysis* |
| Grant Support | |
ID/Acronym/Agency:
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K08DK081479/DK/NIDDK NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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