Publications by authors named "Cary Paine"
Proximal Tubule Secretory Clearance, Injury, and Kidney Viability in Cirrhosis.
Clin Transl Gastroenterol
November 2024
Article Synopsis
- The study examines how cirrhosis affects kidney functionality, particularly focusing on tubular structures, which are crucial for managing metabolites and electrolytes, rather than just glomerular filtration rate (GFR).
- Researchers collected plasma and urine samples from cirrhotic patients and matched controls to evaluate tubular injury and viability markers, specifically KIM-1 (kidney injury molecule-1) and EGF (epidermal growth factor).
- Findings showed that patients with cirrhosis had significantly higher levels of KIM-1 and EGF, indicating tubular injury yet demonstrated preserved tubular secretory function, suggesting a mix of chronic injury while maintaining functionality in stable cirrhosis cases.
Article Synopsis
- Albumin is commonly used in various clinical settings for improving blood flow, fluid removal, and managing cirrhosis complications, leading to guidelines created by the International Collaboration for Transfusion Medicine.
- A dedicated panel, including researchers and a patient representative, developed these guidelines based on a systematic review of existing studies, resulting in 14 recommendations for adult and pediatric critical care, cardiovascular surgery, kidney therapy, and cirrhosis management.
- Most recommendations (12 out of 14) advised against widespread albumin usage in many scenarios, highlighting a lack of strong evidence, with only two recommendations suggesting conditional use in specific cirrhosis cases.
Purpose Of Review: Albumin has repeatedly been shown to be beneficial in treating patients with decompensated cirrhosis. We reviewed the medical literature regarding indications for the use of intravenous albumin in cirrhosis, with particular focus on the ways in which albumin can help mitigate hepatorenal physiology.
Recent Findings: Albumin has long been used as the preferred agent for volume expansion in patients with decompensated cirrhosis.
Treatment of Hyponatremia in End-Stage Liver Disease: New Tools in the Shed.
Am J Gastroenterol
November 2018