Acute kidney injury(AKI)in cirrhosis,including hepatorenal syndrome(HRS),is a common and serious complication in cirrhotic patients,leading to significant morbidity and mortality.AKI is separated into two categories,n...Acute kidney injury(AKI)in cirrhosis,including hepatorenal syndrome(HRS),is a common and serious complication in cirrhotic patients,leading to significant morbidity and mortality.AKI is separated into two categories,non-HRS AKI and HRS-AKI.The most recent definition and diagnostic criteria of AKI in cirrhosis and HRS have helped diagnose and prognosticate the disease.The pathophysiology behind non-HRS-AKI and HRS is more complicated than once theorized and involves more processes than just splanchnic vasodilation.The common biomarkers clinicians use to assess kidney injury have significant limitations in cirrhosis patients;novel biomarkers being studied have shown promise but require further studies in clinical settings and animal models.The overall management of non-HRS AKI and HRS-AKI requires a systematic approach.Although pharmacological treatments have shown mortality benefit,the ideal HRS treatment option is liver transplantation with or without simultaneous kidney transplantation.Further research is required to optimize pharmacologic and nonpharmacologic approaches to treatment.This article reviews the current guidelines and recommendations of AKI in cirrhosis.展开更多
Biogenic palladium nanoparticles(bio-Pd NPs)are used for the reductive transformation and/or dehalogenation of persistent micropollutants.In this work,H2(electron donor)was produced in situ by an electrochemical cell,...Biogenic palladium nanoparticles(bio-Pd NPs)are used for the reductive transformation and/or dehalogenation of persistent micropollutants.In this work,H2(electron donor)was produced in situ by an electrochemical cell,permitting steered production of differently sized bio-Pd NPs.The catalytic activity was first assessed by the degradation of methyl orange.The NPs showing the highest catalytic activity were selected for the removal of micropollutants from secondary treated municipal wastewater.The synthesis at different H2 flow rates(0.310 L/hr or 0.646 L/hr)influenced the bio-Pd NPs size.The NPs produced over 6 hr at a lowH2 flow rate had a larger size(D50=39.0 nm)than those produced in 3 hr at a high H2 flow rate(D50=23.2 nm).Removal of 92.1%and 44.3%of methyl orange was obtained after 30 min for the NPs with sizes of 39.0 nm and 23.2 nm,respectively.Bio-Pd NPs of 39.0 nm were used to treat micropollutants present in secondary treated municipal wastewater at concentrations ranging fromμg/L to ng/L.Effective removal of 8 compounds was observed:ibuprofen(69.5%)<sulfamethoxazole(80.6%)<naproxen(81.4%)<furosemide(89.7%)<citalopram(91.7%)<diclofenac(91.9%)<atorvastatin(>94.3%)<lorazepam(97.2%).Re-moval of fluorinated antibiotics occurred at>90%efficiency.Overall,these data indicate that the size,and thus the catalytic activity of the NPs can be steered and that the removal of challengingmicropollutants at environmentally relevant concentrations can be achieved through the use of bio-Pd NPs.展开更多
文摘Acute kidney injury(AKI)in cirrhosis,including hepatorenal syndrome(HRS),is a common and serious complication in cirrhotic patients,leading to significant morbidity and mortality.AKI is separated into two categories,non-HRS AKI and HRS-AKI.The most recent definition and diagnostic criteria of AKI in cirrhosis and HRS have helped diagnose and prognosticate the disease.The pathophysiology behind non-HRS-AKI and HRS is more complicated than once theorized and involves more processes than just splanchnic vasodilation.The common biomarkers clinicians use to assess kidney injury have significant limitations in cirrhosis patients;novel biomarkers being studied have shown promise but require further studies in clinical settings and animal models.The overall management of non-HRS AKI and HRS-AKI requires a systematic approach.Although pharmacological treatments have shown mortality benefit,the ideal HRS treatment option is liver transplantation with or without simultaneous kidney transplantation.Further research is required to optimize pharmacologic and nonpharmacologic approaches to treatment.This article reviews the current guidelines and recommendations of AKI in cirrhosis.
基金The ELECTRA project has received funding from European Union’s Horizon 2020 research and innovation programunder grant agreement No.826244Eduardo Bolea-Fernandez thanks FWO-Vlaanderen for his postdoctoral grant(No.12ZA320N),The authors would like to thank Victor Lobanov,Mingsheng Jia,and Hira Khan for critically reading the manuscript.
文摘Biogenic palladium nanoparticles(bio-Pd NPs)are used for the reductive transformation and/or dehalogenation of persistent micropollutants.In this work,H2(electron donor)was produced in situ by an electrochemical cell,permitting steered production of differently sized bio-Pd NPs.The catalytic activity was first assessed by the degradation of methyl orange.The NPs showing the highest catalytic activity were selected for the removal of micropollutants from secondary treated municipal wastewater.The synthesis at different H2 flow rates(0.310 L/hr or 0.646 L/hr)influenced the bio-Pd NPs size.The NPs produced over 6 hr at a lowH2 flow rate had a larger size(D50=39.0 nm)than those produced in 3 hr at a high H2 flow rate(D50=23.2 nm).Removal of 92.1%and 44.3%of methyl orange was obtained after 30 min for the NPs with sizes of 39.0 nm and 23.2 nm,respectively.Bio-Pd NPs of 39.0 nm were used to treat micropollutants present in secondary treated municipal wastewater at concentrations ranging fromμg/L to ng/L.Effective removal of 8 compounds was observed:ibuprofen(69.5%)<sulfamethoxazole(80.6%)<naproxen(81.4%)<furosemide(89.7%)<citalopram(91.7%)<diclofenac(91.9%)<atorvastatin(>94.3%)<lorazepam(97.2%).Re-moval of fluorinated antibiotics occurred at>90%efficiency.Overall,these data indicate that the size,and thus the catalytic activity of the NPs can be steered and that the removal of challengingmicropollutants at environmentally relevant concentrations can be achieved through the use of bio-Pd NPs.
