Publications by authors named "X Couto Parada"
Article Synopsis
- There is a significant lack of data on dialysis decision-making for patients with cirrhosis who are ineligible for transplants, prompting this study to explore RRT initiation processes, predictors, and outcomes.
- The research involved evaluating 372 patients with acute kidney injury due to conditions like hepatorenal syndrome, revealing that those who received RRT had a median survival of 12.5 days, compared to just 2 days for those who didn't.
- The study highlights that most patients receiving RRT had short-term mortality and intensive end-of-life care, and it emphasizes the need for better clinical processes for communication and decision-making regarding RRT in this vulnerable population.
Background & Aims: Acute kidney injury (AKI) in cirrhosis is common and associated with high morbidity, but the incidence rates of different etiologies of AKI are not well described in the US. We compared incidence rates, practice patterns, and outcomes across etiologies of AKI in cirrhosis.
Methods: We performed a retrospective cohort study of 11 hospital networks, including consecutive adult patients admitted with AKI and cirrhosis in 2019.
Hepatorenal syndrome (HRS) is a form of acute kidney injury (AKI) occurring in patients with advanced cirrhosis and is associated with significant morbidity and mortality. The pathophysiology underlying HRS begins with increasing portal pressures leading to the release of vasodilatory substances that result in pooling blood in the splanchnic system and a corresponding reduction in effective circulating volume. Compensatory activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system and release of arginine vasopressin serve to defend mean arterial pressure but at the cost of severe constriction of the renal vasculature, leading to a progressive, often fulminant form of AKI.
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- Acute kidney injury (AKI) is more common in hospitalized COVID-19 patients (23%) compared to those with influenza (13%), indicating a higher risk associated with COVID-19.
- Research involved a study of 2,425 patients, where COVID-19 patients had an increased risk of AKI and higher in-hospital mortality rates compared to influenza patients.
- Despite the higher AKI and mortality rates in COVID-19 patients, long-term kidney recovery outcomes seem similar to those of influenza patients after 90 days, suggesting some resilience in kidney recovery.