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Acute kidney injury (AKI) is one of the most severe complications in patients with liver cirrhosis, and its prevention and treatment are a priority in managing these patients. A comprehensive international study published in "The Lancet Gastroenterology & Hepatology" analyzed this condition in over 3,800 patients hospitalized for decompensated cirrhosis in 65 hospitals across 27 countries on five continents. This is the largest study ever conducted on the subject and has highlighted significant differences in how this condition is treated worldwide. These results can help improve care strategies and optimize the clinical management of patients.
The study, titled "Global Epidemiology of Acute Kidney Injury in Hospitalized Patients with Decompensated Cirrhosis: The International Club of Ascites GLOBAL AKI Prospective, Multicentre, Cohort Study," was coordinated by Salvatore Silvio Piano, a professor at the Department of Medicine at the University of Padua and a physician in the Hepatology-focused Internal Medicine Unit at the Hospital-University of Padua.
"Patients with decompensated cirrhosis are particularly vulnerable to acute kidney injury due to the intrinsic characteristics of this syndrome, which is characterized by effective hypovolemia," Piano emphasized. "Blood flow to the kidneys is reduced, and the body activates compensation mechanisms that can further worsen kidney function. Infections, bleeding, or excessive use of diuretics can rapidly trigger AKI, with a dramatic impact on prognosis."
With this new study, the research team aimed to provide a global perspective on the epidemiology and management of AKI in patients with cirrhosis. The study showed that AKI is very common, with 38% of patients hospitalized for cirrhosis complications presenting this condition. The most common form of AKI is secondary to hypovolemia, or a decrease in the blood circulating in the body (59%), while hepatorenal syndrome, often considered the main cause, accounts for only 17% of cases. "This is an important finding," Piano explained, "because it shows that for most patients, it is sufficient to remove the triggering factors and restore plasma volume with fluid administration before resorting to more aggressive therapies like vasoconstrictors."
Additionally, the study revealed significant regional differences in the management of AKI, particularly in the use of therapies such as albumin and terlipressin, which showed wide variability across different regions of the world. The study highlighted that AKI treatment varies greatly between countries, which can affect patient outcomes. Understanding these differences is therefore crucial to improving disease management and increasing survival rates.
AKI was associated with a high risk of mortality: nearly a quarter of patients with AKI (22.9%) died within 28 days. Among the parameters associated with better survival was higher quality and accessibility of care in the involved centers, evaluated with the "Universal Health Coverage" index developed by the World Health Organization.
This study helps to understand how to improve the management of AKI in patients with cirrhosis globally, by optimizing hospital treatments and ensuring equitable and universal access to essential and life-saving treatments such as liver transplantation. The study was funded by the European Association for the Study of the Liver (EASL) and the Italian Society of Internal Medicine (SIMI).
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The study, titled "Global Epidemiology of Acute Kidney Injury in Hospitalized Patients with Decompensated Cirrhosis: The International Club of Ascites GLOBAL AKI Prospective, Multicentre, Cohort Study," was coordinated by Salvatore Silvio Piano, a professor at the Department of Medicine at the University of Padua and a physician in the Hepatology-focused Internal Medicine Unit at the Hospital-University of Padua.
"Patients with decompensated cirrhosis are particularly vulnerable to acute kidney injury due to the intrinsic characteristics of this syndrome, which is characterized by effective hypovolemia," Piano emphasized. "Blood flow to the kidneys is reduced, and the body activates compensation mechanisms that can further worsen kidney function. Infections, bleeding, or excessive use of diuretics can rapidly trigger AKI, with a dramatic impact on prognosis."
With this new study, the research team aimed to provide a global perspective on the epidemiology and management of AKI in patients with cirrhosis. The study showed that AKI is very common, with 38% of patients hospitalized for cirrhosis complications presenting this condition. The most common form of AKI is secondary to hypovolemia, or a decrease in the blood circulating in the body (59%), while hepatorenal syndrome, often considered the main cause, accounts for only 17% of cases. "This is an important finding," Piano explained, "because it shows that for most patients, it is sufficient to remove the triggering factors and restore plasma volume with fluid administration before resorting to more aggressive therapies like vasoconstrictors."
Additionally, the study revealed significant regional differences in the management of AKI, particularly in the use of therapies such as albumin and terlipressin, which showed wide variability across different regions of the world. The study highlighted that AKI treatment varies greatly between countries, which can affect patient outcomes. Understanding these differences is therefore crucial to improving disease management and increasing survival rates.
AKI was associated with a high risk of mortality: nearly a quarter of patients with AKI (22.9%) died within 28 days. Among the parameters associated with better survival was higher quality and accessibility of care in the involved centers, evaluated with the "Universal Health Coverage" index developed by the World Health Organization.
This study helps to understand how to improve the management of AKI in patients with cirrhosis globally, by optimizing hospital treatments and ensuring equitable and universal access to essential and life-saving treatments such as liver transplantation. The study was funded by the European Association for the Study of the Liver (EASL) and the Italian Society of Internal Medicine (SIMI).
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"Patients with decompensated cirrhosis are particularly vulnerable to acute kidney injury due to the intrinsic characteristics of this syndrome, which is characterized by effective hypovolemia," Piano emphasized. "Blood flow to the kidneys is reduced, and the body activates compensation mechanisms that can further worsen kidney function. Infections, bleeding, or excessive use of diuretics can rapidly trigger AKI, with a dramatic impact on prognosis."
With this new study, the research team aimed to provide a global perspective on the epidemiology and management of AKI in patients with cirrhosis. The study showed that AKI is very common, with 38% of patients hospitalized for cirrhosis complications presenting this condition. The most common form of AKI is secondary to hypovolemia, or a decrease in the blood circulating in the body (59%), while hepatorenal syndrome, often considered the main cause, accounts for only 17% of cases. "This is an important finding," Piano explained, "because it shows that for most patients, it is sufficient to remove the triggering factors and restore plasma volume with fluid administration before resorting to more aggressive therapies like vasoconstrictors."
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AKI was associated with a high risk of mortality: nearly a quarter of patients with AKI (22.9%) died within 28 days. Among the parameters associated with better survival was higher quality and accessibility of care in the involved centers, evaluated with the "Universal Health Coverage" index developed by the World Health Organization.
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"Patients with decompensated cirrhosis are particularly vulnerable to acute kidney injury due to the intrinsic characteristics of this syndrome, which is characterized by effective hypovolemia," Piano emphasized. "Blood flow to the kidneys is reduced, and the body activates compensation mechanisms that can further worsen kidney function. Infections, bleeding, or excessive use of diuretics can rapidly trigger AKI, with a dramatic impact on prognosis."
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The study, titled "Global Epidemiology of Acute Kidney Injury in Hospitalized Patients with Decompensated Cirrhosis: The International Club of Ascites GLOBAL AKI Prospective, Multicentre, Cohort Study," was coordinated by Salvatore Silvio Piano, a professor at the Department of Medicine at the University of Padua and a physician in the Hepatology-focused Internal Medicine Unit at the Hospital-University of Padua.
"Patients with decompensated cirrhosis are particularly vulnerable to acute kidney injury due to the intrinsic characteristics of this syndrome, which is characterized by effective hypovolemia," Piano emphasized. "Blood flow to the kidneys is reduced, and the body activates compensation mechanisms that can further worsen kidney function. Infections, bleeding, or excessive use of diuretics can rapidly trigger AKI, with a dramatic impact on prognosis."
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Acute kidney injury (AKI) is one of the most severe complications in patients with liver cirrhosis, and its prevention and treatment are a priority in managing these patients. A comprehensive international study published in "The Lancet Gastroenterology & Hepatology" analyzed this condition in over 3,800 patients hospitalized for decompensated cirrhosis in 65 hospitals across 27 countries on five continents. This is the largest study ever conducted on the subject and has highlighted significant differences in how this condition is treated worldwide. These results can help improve care strategies and optimize the clinical management of patients.
The study, titled "Global Epidemiology of Acute Kidney Injury in Hospitalized Patients with Decompensated Cirrhosis: The International Club of Ascites GLOBAL AKI Prospective, Multicentre, Cohort Study," was coordinated by Salvatore Silvio Piano, a professor at the Department of Medicine at the University of Padua and a physician in the Hepatology-focused Internal Medicine Unit at the Hospital-University of Padua.
"Patients with decompensated cirrhosis are particularly vulnerable to acute kidney injury due to the intrinsic characteristics of this syndrome, which is characterized by effective hypovolemia," Piano emphasized. "Blood flow to the kidneys is reduced, and the body activates compensation mechanisms that can further worsen kidney function. Infections, bleeding, or excessive use of diuretics can rapidly trigger AKI, with a dramatic impact on prognosis."
With this new study, the research team aimed to provide a global perspective on the epidemiology and management of AKI in patients with cirrhosis. The study showed that AKI is very common, with 38% of patients hospitalized for cirrhosis complications presenting this condition. The most common form of AKI is secondary to hypovolemia, or a decrease in the blood circulating in the body (59%), while hepatorenal syndrome, often considered the main cause, accounts for only 17% of cases. "This is an important finding," Piano explained, "because it shows that for most patients, it is sufficient to remove the triggering factors and restore plasma volume with fluid administration before resorting to more aggressive therapies like vasoconstrictors."
Additionally, the study revealed significant regional differences in the management of AKI, particularly in the use of therapies such as albumin and terlipressin, which showed wide variability across different regions of the world. The study highlighted that AKI treatment varies greatly between countries, which can affect patient outcomes. Understanding these differences is therefore crucial to improving disease management and increasing survival rates.
AKI was associated with a high risk of mortality: nearly a quarter of patients with AKI (22.9%) died within 28 days. Among the parameters associated with better survival was higher quality and accessibility of care in the involved centers, evaluated with the "Universal Health Coverage" index developed by the World Health Organization.
This study helps to understand how to improve the management of AKI in patients with cirrhosis globally, by optimizing hospital treatments and ensuring equitable and universal access to essential and life-saving treatments such as liver transplantation. The study was funded by the European Association for the Study of the Liver (EASL) and the Italian Society of Internal Medicine (SIMI).
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The study, titled "Global Epidemiology of Acute Kidney Injury in Hospitalized Patients with Decompensated Cirrhosis: The International Club of Ascites GLOBAL AKI Prospective, Multicentre, Cohort Study," was coordinated by Salvatore Silvio Piano, a professor at the Department of Medicine at the University of Padua and a physician in the Hepatology-focused Internal Medicine Unit at the Hospital-University of Padua.
"Patients with decompensated cirrhosis are particularly vulnerable to acute kidney injury due to the intrinsic characteristics of this syndrome, which is characterized by effective hypovolemia," Piano emphasized. "Blood flow to the kidneys is reduced, and the body activates compensation mechanisms that can further worsen kidney function. Infections, bleeding, or excessive use of diuretics can rapidly trigger AKI, with a dramatic impact on prognosis."
With this new study, the research team aimed to provide a global perspective on the epidemiology and management of AKI in patients with cirrhosis. The study showed that AKI is very common, with 38% of patients hospitalized for cirrhosis complications presenting this condition. The most common form of AKI is secondary to hypovolemia, or a decrease in the blood circulating in the body (59%), while hepatorenal syndrome, often considered the main cause, accounts for only 17% of cases. "This is an important finding," Piano explained, "because it shows that for most patients, it is sufficient to remove the triggering factors and restore plasma volume with fluid administration before resorting to more aggressive therapies like vasoconstrictors."
Additionally, the study revealed significant regional differences in the management of AKI, particularly in the use of therapies such as albumin and terlipressin, which showed wide variability across different regions of the world. The study highlighted that AKI treatment varies greatly between countries, which can affect patient outcomes. Understanding these differences is therefore crucial to improving disease management and increasing survival rates.
AKI was associated with a high risk of mortality: nearly a quarter of patients with AKI (22.9%) died within 28 days. Among the parameters associated with better survival was higher quality and accessibility of care in the involved centers, evaluated with the "Universal Health Coverage" index developed by the World Health Organization.
This study helps to understand how to improve the management of AKI in patients with cirrhosis globally, by optimizing hospital treatments and ensuring equitable and universal access to essential and life-saving treatments such as liver transplantation. The study was funded by the European Association for the Study of the Liver (EASL) and the Italian Society of Internal Medicine (SIMI).
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The study, titled "Global Epidemiology of Acute Kidney Injury in Hospitalized Patients with Decompensated Cirrhosis: The International Club of Ascites GLOBAL AKI Prospective, Multicentre, Cohort Study," was coordinated by Salvatore Silvio Piano, a professor at the Department of Medicine at the University of Padua and a physician in the Hepatology-focused Internal Medicine Unit at the Hospital-University of Padua.
"Patients with decompensated cirrhosis are particularly vulnerable to acute kidney injury due to the intrinsic characteristics of this syndrome, which is characterized by effective hypovolemia," Piano emphasized. "Blood flow to the kidneys is reduced, and the body activates compensation mechanisms that can further worsen kidney function. Infections, bleeding, or excessive use of diuretics can rapidly trigger AKI, with a dramatic impact on prognosis."
With this new study, the research team aimed to provide a global perspective on the epidemiology and management of AKI in patients with cirrhosis. The study showed that AKI is very common, with 38% of patients hospitalized for cirrhosis complications presenting this condition. The most common form of AKI is secondary to hypovolemia, or a decrease in the blood circulating in the body (59%), while hepatorenal syndrome, often considered the main cause, accounts for only 17% of cases. "This is an important finding," Piano explained, "because it shows that for most patients, it is sufficient to remove the triggering factors and restore plasma volume with fluid administration before resorting to more aggressive therapies like vasoconstrictors."
Additionally, the study revealed significant regional differences in the management of AKI, particularly in the use of therapies such as albumin and terlipressin, which showed wide variability across different regions of the world. The study highlighted that AKI treatment varies greatly between countries, which can affect patient outcomes. Understanding these differences is therefore crucial to improving disease management and increasing survival rates.
AKI was associated with a high risk of mortality: nearly a quarter of patients with AKI (22.9%) died within 28 days. Among the parameters associated with better survival was higher quality and accessibility of care in the involved centers, evaluated with the "Universal Health Coverage" index developed by the World Health Organization.
This study helps to understand how to improve the management of AKI in patients with cirrhosis globally, by optimizing hospital treatments and ensuring equitable and universal access to essential and life-saving treatments such as liver transplantation. The study was funded by the European Association for the Study of the Liver (EASL) and the Italian Society of Internal Medicine (SIMI).
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The study, titled "Global Epidemiology of Acute Kidney Injury in Hospitalized Patients with Decompensated Cirrhosis: The International Club of Ascites GLOBAL AKI Prospective, Multicentre, Cohort Study," was coordinated by Salvatore Silvio Piano, a professor at the Department of Medicine at the University of Padua and a physician in the Hepatology-focused Internal Medicine Unit at the Hospital-University of Padua.
"Patients with decompensated cirrhosis are particularly vulnerable to acute kidney injury due to the intrinsic characteristics of this syndrome, which is characterized by effective hypovolemia," Piano emphasized. "Blood flow to the kidneys is reduced, and the body activates compensation mechanisms that can further worsen kidney function. Infections, bleeding, or excessive use of diuretics can rapidly trigger AKI, with a dramatic impact on prognosis."
With this new study, the research team aimed to provide a global perspective on the epidemiology and management of AKI in patients with cirrhosis. The study showed that AKI is very common, with 38% of patients hospitalized for cirrhosis complications presenting this condition. The most common form of AKI is secondary to hypovolemia, or a decrease in the blood circulating in the body (59%), while hepatorenal syndrome, often considered the main cause, accounts for only 17% of cases. "This is an important finding," Piano explained, "because it shows that for most patients, it is sufficient to remove the triggering factors and restore plasma volume with fluid administration before resorting to more aggressive therapies like vasoconstrictors."
Additionally, the study revealed significant regional differences in the management of AKI, particularly in the use of therapies such as albumin and terlipressin, which showed wide variability across different regions of the world. The study highlighted that AKI treatment varies greatly between countries, which can affect patient outcomes. Understanding these differences is therefore crucial to improving disease management and increasing survival rates.
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This study helps to understand how to improve the management of AKI in patients with cirrhosis globally, by optimizing hospital treatments and ensuring equitable and universal access to essential and life-saving treatments such as liver transplantation. The study was funded by the European Association for the Study of the Liver (EASL) and the Italian Society of Internal Medicine (SIMI).
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"Patients with decompensated cirrhosis are particularly vulnerable to acute kidney injury due to the intrinsic characteristics of this syndrome, which is characterized by effective hypovolemia," Piano emphasized. "Blood flow to the kidneys is reduced, and the body activates compensation mechanisms that can further worsen kidney function. Infections, bleeding, or excessive use of diuretics can rapidly trigger AKI, with a dramatic impact on prognosis."
With this new study, the research team aimed to provide a global perspective on the epidemiology and management of AKI in patients with cirrhosis. The study showed that AKI is very common, with 38% of patients hospitalized for cirrhosis complications presenting this condition. The most common form of AKI is secondary to hypovolemia, or a decrease in the blood circulating in the body (59%), while hepatorenal syndrome, often considered the main cause, accounts for only 17% of cases. "This is an important finding," Piano explained, "because it shows that for most patients, it is sufficient to remove the triggering factors and restore plasma volume with fluid administration before resorting to more aggressive therapies like vasoconstrictors."
Additionally, the study revealed significant regional differences in the management of AKI, particularly in the use of therapies such as albumin and terlipressin, which showed wide variability across different regions of the world. The study highlighted that AKI treatment varies greatly between countries, which can affect patient outcomes. Understanding these differences is therefore crucial to improving disease management and increasing survival rates.
AKI was associated with a high risk of mortality: nearly a quarter of patients with AKI (22.9%) died within 28 days. Among the parameters associated with better survival was higher quality and accessibility of care in the involved centers, evaluated with the "Universal Health Coverage" index developed by the World Health Organization.
This study helps to understand how to improve the management of AKI in patients with cirrhosis globally, by optimizing hospital treatments and ensuring equitable and universal access to essential and life-saving treatments such as liver transplantation. The study was funded by the European Association for the Study of the Liver (EASL) and the Italian Society of Internal Medicine (SIMI).
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The study, titled "Global Epidemiology of Acute Kidney Injury in Hospitalized Patients with Decompensated Cirrhosis: The International Club of Ascites GLOBAL AKI Prospective, Multicentre, Cohort Study," was coordinated by Salvatore Silvio Piano, a professor at the Department of Medicine at the University of Padua and a physician in the Hepatology-focused Internal Medicine Unit at the Hospital-University of Padua.
"Patients with decompensated cirrhosis are particularly vulnerable to acute kidney injury due to the intrinsic characteristics of this syndrome, which is characterized by effective hypovolemia," Piano emphasized. "Blood flow to the kidneys is reduced, and the body activates compensation mechanisms that can further worsen kidney function. Infections, bleeding, or excessive use of diuretics can rapidly trigger AKI, with a dramatic impact on prognosis."
With this new study, the research team aimed to provide a global perspective on the epidemiology and management of AKI in patients with cirrhosis. The study showed that AKI is very common, with 38% of patients hospitalized for cirrhosis complications presenting this condition. The most common form of AKI is secondary to hypovolemia, or a decrease in the blood circulating in the body (59%), while hepatorenal syndrome, often considered the main cause, accounts for only 17% of cases. "This is an important finding," Piano explained, "because it shows that for most patients, it is sufficient to remove the triggering factors and restore plasma volume with fluid administration before resorting to more aggressive therapies like vasoconstrictors."
Additionally, the study revealed significant regional differences in the management of AKI, particularly in the use of therapies such as albumin and terlipressin, which showed wide variability across different regions of the world. The study highlighted that AKI treatment varies greatly between countries, which can affect patient outcomes. Understanding these differences is therefore crucial to improving disease management and increasing survival rates.
AKI was associated with a high risk of mortality: nearly a quarter of patients with AKI (22.9%) died within 28 days. Among the parameters associated with better survival was higher quality and accessibility of care in the involved centers, evaluated with the "Universal Health Coverage" index developed by the World Health Organization.
This study helps to understand how to improve the management of AKI in patients with cirrhosis globally, by optimizing hospital treatments and ensuring equitable and universal access to essential and life-saving treatments such as liver transplantation. The study was funded by the European Association for the Study of the Liver (EASL) and the Italian Society of Internal Medicine (SIMI).
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