Browsing by Author "Lau, G."

Filter results by typing the first few letters
Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    APASL clinical practice guidelines on the management of acute kidney injury in acute-on-chronic liver failure.
    (Springer, 2024) Maiwall, R.; Singh, S.P.; Angeli, P.; Moreau, R.; Krag, A.; Singh, V.; Singal, A.K.; Tan, S.S.; Puri, P.; Mahtab, M.; Lau, G.; Ning, Q.; Sharma, M.K.; Rao, P.N.; Kapoor, D.; Gupta, S.; Duseja, A.; Wadhawan, M.; Jothimani, D.; Saigal, S.; Taneja, S.; Shukla, A.; Govil, D.; Pandey, G.; Madan, K.; Eapen, C.E.; Benjamin, J.; Chowdhury, A.; Salao, V.; Yang, J.M.; Hamid, S.; Shalimar; Jasuja, S.; Kulkarni, A.V.; Niriella, M.A.; Tevethia, H.V.; Arora, V.; Mathur, R.P.; Roy, A.; Jindal, A.; Saraf, N.; Verma, N.; Arka, D.; Choudhary, N.S.; Mehtani, R.; Chand, P.; Rudra, O.; Sarin, S.K.; Puri, P.; Singh, S.
    Acute-on-chronic liver failure (ACLF) is a syndrome that is characterized by the rapid development of organ failures predisposing these patients to a high risk of short-term early death. The main causes of organ failure in these patients are bacterial infections and systemic inflammation, both of which can be severe. For the majority of these patients, a prompt liver transplant is still the only effective course of treatment. Kidneys are one of the most frequent extrahepatic organs that are affected in patients with ACLF, since acute kidney injury (AKI) is reported in 22.8-34% of patients with ACLF. Approach and management of kidney injury could improve overall outcomes in these patients. Importantly, patients with ACLF more frequently have stage 3 AKI with a low rate of response to the current treatment modalities. The objective of the present position paper is to critically review and analyze the published data on AKI in ACLF, evolve a consensus, and provide recommendations for early diagnosis, pathophysiology, prevention, and management of AKI in patients with ACLF. In the absence of direct evidence, we propose expert opinions for guidance in managing AKI in this very challenging group of patients and focus on areas of future research. This consensus will be of major importance to all hepatologists, liver transplant surgeons, and intensivists across the globe.
  • No Thumbnail Available
    Item
    A global survey on the use of the international classification of diseases codes for metabolic dysfunction-associated fatty liver disease
    (Springer, 2024) Zhang, H.; Targher, G.; Byrne, C.D.; Kim, S.U.; Wong, V.W.; Valenti, L.; Glickman, M.; Ponce, J.; Mantzoros, C.S.; Crespo, J.; Gronbaek, H.; Yang, W.; Eslam, M.; Wong, R.J.; Machado, M.V.; Yu, M.; Ghanem, O.M.; Okanoue, T.; Liu, J.; Lee, Y.; Xu, X.; Pan, Q.; Sui, M.; Lonardo, A.; Yilmaz, Y.; Zhu, L.; Moreno, C.; Miele, L.; Lupsor-Platon, M.; Zhao, L.; LaMasters, T.L.; Gish, R.G.; Zhang, H.; Nedelcu, M.; Chan, W.K.; Xia, M.; Bril, F.; Shi, J.; Datz, C.; Romeo, S.; Sun, J.; Liu, D.; Sookoian, S.; Mao, Y.; Méndez-Sánchez, N.; Wang, X.; Pyrsopoulos, N.T.; Fan, J.; Fouad, Y.; Sun, D.; Giannini, C.; Chai, J.; Xia, Z.; Jun, D.W.; Li, G.; Treeprasertsuk, S.; Li, Y.; Cheung, T.T.; Zhang, F.; Goh, G.B.; Furuhashi, M.; Seto, W.; Huang, H.; Sessa, A.D.; Li, Q.; Cholongitas, E.; Zhang, L.; Silveira, T.R.; Sebastiani, G.; Adams, L.A.; Chen, W.; Qi, X.; Rankovic, I.; Ledinghen, V.D.; Lv, W.; Hamaguchi, M.; Kassir, R.; Müller-Wieland, D.; Romero-Gomez, M.; Xu, Y.; Xu, Y.; Chen, S.; Kermansaravi, M.; Kuchay, M.S.; Lefere, S.; Parmar, C.; Lip, G.Y.H.; Liu, C.; Åberg, F.; Lau, G.; George, J.; Sarin, S.K.; Zhou, J.; Zheng, M.; Niriella, M.A. (MAFLD ICD-11 coding collaborators)
    BACKGROUND With the implementation of the 11th edition of the International Classification of Diseases (ICD-11) and the publication of the metabolic dysfunction-associated fatty liver disease (MAFLD) nomenclature in 2020, it is important to establish consensus for the coding of MAFLD in ICD-11. This will inform subsequent revisions of ICD-11.METHODS Using the Qualtrics XM and WJX platforms, questionnaires were sent online to MAFLD-ICD-11 coding collaborators, authors of papers, and relevant association members.RESULTS A total of 890 international experts in various fields from 61 countries responded to the survey. We also achieved full coverage of provincial-level administrative regions in China. 77.1% of respondents agreed that MAFLD should be represented in ICD-11 by updating NAFLD, with no significant regional differences (77.3% in Asia and 76.6% in non-Asia, p = 0.819). Over 80% of respondents agreed or somewhat agreed with the need to assign specific codes for progressive stages of MAFLD (i.e. steatohepatitis) (92.2%), MAFLD combined with comorbidities (84.1%), or MAFLD subtypes (i.e., lean, overweight/obese, and diabetic) (86.1%).CONCLUSIONS This global survey by a collaborative panel of clinical, coding, health management and policy experts, indicates agreement that MAFLD should be coded in ICD-11. The data serves as a foundation for corresponding adjustments in the ICD-11 revision.
  • No Thumbnail Available
    Item
    Premorbid blood pressure control of incident transient ischaemic attacks and strokes; prevalence and determinants; Analysis of individual patient data over 10 Years
    (Lippincott Williams & Wilkins, 2017) Mettananda, C.; Li, L.; Lau, G.; Wharton, R.; Bull, L.; McCulloch, E.; Welch, S.; Mehta, Z.; Silver, L.; Rothwell, P.; Oxford Vascular Study
    BACKGROUND: Uncontrolled blood pressure is the most important modifiable risk factor for strokes. AIMS AND METHODS: We determined the prevalence and determinants of blood pressure control in patients with incident transient ischaemic attacks(TIA) and strokes from 2002-2012 in a population-based cohort(Oxford Vascular Study). Controlled blood pressure(BP) was defined as having BP<140/90mmHg and was studied in different cardiovascular risk groups according to the Framingham 10-year general cardiovascular risk(CV-Risk) predicted at time of event and 10years pre-event; low(≤ 10%), moderate(11-19%) and high(≥ 20%) risk. We also studied the associations of controlled BP adjusted for age and sex. RESULTS: Among 1741 patients with incident TIA/strokes, 1051 (60.4%) had known hypertension, of which 891 (84.8%) were on anti-hypertensive treatment. However, only 698 (40.1%) of all and 306 (29.1%) of treated patients had controlled BP. On predicted 10-year CV-Risk at event, 861 (72.5%) of 1188 (77.0%) in high risk group had known hypertension, of which 758 (88.0%) were on treatment. However, only 346 (29.1%) of all in high-risk group and 190 (25.1%) of treated high risk patients had controlled BP. In contrast, 120 (88.2%) of 136 (8.8%) in low risk group had controlled BP. Risk stratification without scoring for BP showed consistent results except the number in high-risk group dropped to 863 (55.9%). Analysis with CV-risk 10years pre-event also showed similar trends. Age(adjusted OR=0.97, 95%CI=0.97-0.98, p<0.001), high CV-risk at event/10years pre-event (0.97, 0.95-0.99, p<0.013, 0.95-0.99, p=0.008), being treated for hypertension(0.43, 0.35-0.52, p<0.001), BMI≥ 30Kg/m2(0.72, 0.55-0.92, p=0.010) and high total cholesterol(0.91, 0.84-0.99, p<0.026) were negatively associated with controlled BP. However history of atrial fibrillation(1.35, 1.03-1.77, p=0.030) and physical dependency(modified-Rankin-Scale>2; 1.54, 1.15-2.06, p<0.001) were positively associated with controlled BP. CONCLUSIONS: Premorbid blood pressure control in patients with incident TIA/strokes was inadequate especially in high-risk patients. Controlling BP to targets in elderly and high CV-risk patients would be important in reducing incident TIA/strokes.