{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T20:20:30Z","timestamp":1790367630454,"version":"4.1.0"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2021,1,2]],"date-time":"2021-01-02T00:00:00Z","timestamp":1609545600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,1,2]],"date-time":"2021-01-02T00:00:00Z","timestamp":1609545600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Liver Transpl."],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p>Transjugular intrahepatic portosystemic shunt (TIPS) is an effective intervention for portal hypertensive complications, but its effect on renal function is not well characterized. Here we describe renal function and characteristics associated with renal dysfunction at 30 days post\u2010TIPS. Adults with cirrhosis who underwent TIPS at 9 hospitals in the United States from 2010 to 2015 were included. We defined \u201cpost\u2010TIPS renal dysfunction\u201d as a change in estimated glomerular filtration rate (\u0394eGFR) \u2264\u221215 and eGFR\u00a0\u2264\u00a060\u00a0mL\/min\/1.73\u00a0m<jats:sup>2<\/jats:sup> or new renal replacement therapy (RRT) at day 30. We identified the characteristics associated with post\u2010TIPS renal dysfunction by logistic regression and evaluated survival using adjusted competing risk regressions. Of the 673 patients, the median age was 57 years, 38% of the patients were female, 26% had diabetes mellitus, and the median MELD\u2010Na was 17. After 30 days post\u2010TIPS, 66 (10%) had renal dysfunction, of which 23 (35%) required new RRT. Patients with post\u2010TIPS renal dysfunction, compared with those with stable renal function, were more likely to have nonalcoholic fatty liver disease (NAFLD; 33% versus 17%; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.01) and comorbid diabetes mellitus (42% versus 24%; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.001). Multivariate logistic regressions showed NAFLD (odds ratio [OR], 2.04; 95% confidence interval [CI], 1.00\u20104.17; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.05), serum sodium (Na; OR, 1.06 per mEq\/L; 95% CI, 1.01\u20101.12; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.03), and diabetes mellitus (OR, 2.04; 95% CI, 1.16\u20103.61; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.01) were associated with post\u2010TIPS renal dysfunction. Competing risk regressions showed that those with post\u2010TIPS renal dysfunction were at a higher subhazard of death (subhazard ratio, 1.74; 95% CI, 1.18\u20102.56; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.01). In this large, multicenter cohort, we found NAFLD, diabetes mellitus, and baseline Na associated with post\u2010TIPS renal dysfunction. This study suggests that patients with NAFLD and diabetes mellitus undergoing TIPS evaluation may require additional attention to cardiac and renal comorbidities before proceeding with the procedure.<\/jats:p>","DOI":"10.1002\/lt.25949","type":"journal-article","created":{"date-parts":[[2020,11,20]],"date-time":"2020-11-20T20:50:32Z","timestamp":1605905432000},"page":"329-340","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":19,"title":["Nonalcoholic Fatty Liver Disease and Diabetes Mellitus Are Associated With Post\u2013Transjugular Intrahepatic Portosystemic Shunt Renal Dysfunction: An Advancing Liver Therapeutic Approaches Group Study"],"prefix":"10.1097","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1574-1525","authenticated-orcid":false,"given":"Jin","family":"Ge","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine,University of California\u2010San Francisco,San Francisco,CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2092-6380","authenticated-orcid":false,"given":"Jennifer C.","family":"Lai","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine,University of California\u2010San Francisco,San Francisco,CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9364-8807","authenticated-orcid":false,"given":"Justin Richard","family":"Boike","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine,Northwestern University Feinberg School of Medicine,Chicago,IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3337-6760","authenticated-orcid":false,"given":"Margarita","family":"German","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine,University of Wisconsin School of Medicine and Public Health,Madison,WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathaniel","family":"Jest","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine,University of Florida Health,Gainesville,FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Morelli","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine,University of Florida Health,Gainesville,FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Spengler","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine,University of Wisconsin School of Medicine and Public Health,Madison,WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9944-4071","authenticated-orcid":false,"given":"Adnan","family":"Said","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine,University of Wisconsin School of Medicine and Public Health,Madison,WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine,University of Wisconsin School of Medicine and Public Health,Madison,WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Hristov","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine,University of Wisconsin School of Medicine and Public Health,Madison,WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Archita P.","family":"Desai","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine,Indiana University School of Medicine,Indianapolis,IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shilpa","family":"Junna","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine,College of Medicine University of Arizona,Tucson,AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhupesh","family":"Pokhrel","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine,College of Medicine University of Arizona,Tucson,AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1610-8978","authenticated-orcid":false,"given":"Thomas","family":"Couri","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Nutrition, Department of Internal Medicine,The University of Chicago Medicine,Chicago,IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonali","family":"Paul","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Nutrition, Department of Internal Medicine,The University of Chicago Medicine,Chicago,IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2245-8173","authenticated-orcid":false,"given":"Catherine","family":"Frenette","sequence":"additional","affiliation":[{"name":"Department for Organ and Cell Transplantation,The Scripps Clinic,La 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