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Hepatocardiorenal syndrome in liver cirrhosis:Recognition of a new entity?

World Journal of Gastroenterology 2024年第2期30卷 128-136页

作者： Henry H L Wu Amina Rakisheva arvind ponnusamy Rajkumar Chinnadurai Renal Research Kolling Institute of Medical ResearchRoyal North Shore Hospital&The University of SydneySt.Leonards(Sydney)2065New South WalesAustralia Department of Cardiology City Cardiological CenterAlmaty 050000Kazakhstan Department of Renal Medicine Royal Preston HospitalPreston PR29HTUnited Kingdom Donal O’Donoghue Renal Research Centre&Department of Renal Medicine Northern Care Alliance National Health Service Foundation TrustSalford M68HDUnited Kingdom

Emerging evidence and perspectives have pointed towards the heart playing an important role in hepatorenal syndrome(HRS),outside of conventional understanding that liver cirrhosis is traditionally considered the sole origin of a cascade of pathophysiological mechanisms directly affecting the kidneys in this *** the absence of established heart disease,cirrhotic cardiomyopathy may occur more frequently in those with liver cirrhosis and kidney *** is a specific form of cardiac dysfunction characterized by blunted contractile responsiveness to stress stimuli and altered diastolic relaxation with electrophysiological *** the clinical description of these potential cardiac-related complications of the liver,the role of the heart has traditionally been an overlooked aspect of circulatory dysfunction in *** from a physiological sense,temporality(prior onset)of cardiorenal interactions in HRS and positive effects stemming from portosystemic shunting demonstrated an important role of the heart in the development and progression of kidney dysfunction in cirrhotic *** this review,we discuss current concepts surrounding how the heart may influence the development and progression of HRS,and the role of systemic inflammation and endothelial dysfunction causing circulatory dysfunction within this *** temporality of heart and kidney dysfunction in HRS will be *** a subgroup of patients who receive portosystemic shunting,the dynamics of cardiorenal interactions following treatment is *** research to determine the unknowns in this topic is anticipated,hopefully to further clarify the intricacies surrounding the liver-heart-kidney connection and improve strategies for management.

关键词： Hepatorenal syndrome Cardiorenal syndrome Cirrhosis Cardiac dysfunction Circulatory dysfunction

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Native and transplant kidney histopathological manifestations in association with COVID-19 infection: A systematic review

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World Journal of Transplantation 2021年第11期11卷 480-502页

作者： Vishnu Jeyalan Joshua Storrar Henry H L Wu arvind ponnusamy Smeeta Sinha Philip A Kalra Rajkumar Chinnadurai Department of Renal Medicine Royal Preston HospitalPreston PR29HTUnited Kingdom Department of Renal Medicine Salford Care OrganisationNorthern Care Alliance NHS Foundation TrustSalford M68HDUnited Kingdom Faculty of Biology Medicine and HealthUniversity of ManchesterManchester M139PLUnited Kingdom

BACKGROUND Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)can result in clinically significant multi-system disease including involvement in the *** underlying histopathological processes were unknown at the start of the *** case reports and series have been published describing the underlying renal histopathology from kidney biopsies,we have started to gain an insight into the renal manifestations of this novel *** To provide an overview of the current literature on the renal histopathological features and mechanistic insights described in association with coronavirus disease 2019(COVID-19)*** A systematic review was performed by conducting a literature search in the following websites-‘PubMed’,‘Web of Science’,‘Embase’and‘Medline-ProQuest’with the following search terms-“COVID-19 AND kidney biopsy”,“COVID-19 AND renal biopsy”,“SARS-CoV-2 AND kidney biopsy”and“SARS-CoV-2 AND renal biopsy”.We have included published data up until February 15,2021,which includes kidney biopsies(native,transplant and postmortem)from patients with *** on clinical presentation,histopathological features,management and outcome was extracted from the reported *** The total number of biopsies reported on here is 288,of which 189 are postmortem,84 native and 15 *** results are varied and show underlying pathologies ranging from collapsing glomerulopathy and acute tubular injury(ATI)to anti-nuclear cytoplasmic antibody associated vasculitis and pigment *** was variation in the specific treatment used for the various renal conditions,which included steroids,hydroxychloroquine,eculizumab,convalescent plasma,rituximab,anakinra,cyclophosphamide and renal replacement therapy,amongst *** pathological process which occurs in the kidney following COVID-19 infection and leads to the described biopsy findings has been hypothesized in some conditions but not others(for example,sepsis related hypoperf

关键词： COVID-19 Histopathology Kidney biopsy Transplant SARS-CoV-2

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