Solé Padullés, CristinaSolà, ElsaHuelin, PatriciaCarol, MartaMoreira, RebecaCereijo, UnaiMas, José ManuelGraupera, IsabelPose Méndez, ElisaNapoleone, Laurade la Prada, GloriaJuanola, AdriàFabrellas i Padrès, NúriaTorres, FerranMorales Ruiz, ManuelFarrés, JudithJiménez Povedano, WladimiroGinès i Gibert, Pere2020-11-302020-11-302018-12-291478-3223https://hdl.handle.net/2445/172405Background: Several lines of evidence indicate that decompensated cirrhosis is characterized by the presence of systemic inflammation. Hepatorenal syndrome (HRS-AKI) is a unique type of renal failure that occurs at late stages of cirrhosis. However, confirmation of the presence and significance of such inflammatory response in HRS-AKI is lacking. Aim and methods: To characterize the systemic inflammatory response, as estimated by measuring a large number of cytokines, in 161 patients hospitalized for an acute decompensation of cirrhosis: 44 patients without acute kidney injury (AKI), 63 patients with hypovolaemia-induced AKI and 58 patients with HRS-AKI. Results: HRS-AKI was characterized by an altered cytokine profile compared to the other two groups, particularly IL-6, IL-8, TNF-α, VCAM-1, fractalkine and MIP-1α. The inflammatory response was not related to presence of bacterial infection, concomitant acute-on-chronic liver failure or severity of renal dysfunction. Patients who responded to terlipressin and albumin had only a decrease in TNF-α and RANTES after treatment without changes in other cytokines. Interestingly, patients with persistent HRS-AKI had higher levels of IP-10 and VCAM-1 compared to those with resolution of HRS-AKI. VCAM-1 was also an independent predictor of 3-month mortality. A systems biology analysis approach showed that the inflammatory status of HRS-AKI was similar to that of chronic nonhepatic inflammatory conditions, such as lupus erythematosus or inflammatory bowel disease. Conclusion: Hepatorenal syndrome is characterized by a marked systemic inflammatory state, reminiscent of that of nonhepatic inflammatory diseases, that correlates with patient outcomes.10 p.application/pdfengcc-by (c) Solé Padullés, et. al., 2018http://creativecommons.org/licenses/by/3.0/es/Cirrosi hepàticaSíndrome hepatorenalInflamacióHepatic cirrhosisHepatorenal syndromeInflammationinfo:eu-repo/semantics/article6900412020-11-30info:eu-repo/semantics/openAccess30597709