Journal of Renal and Hepatic Disorders <p><img style="padding-right: 15px; padding-bottom: 15px; float: left;" src="/public/site/images/jdisord/Jrenhep_logo_png_1001.png">Journal of Renal and Hepatic Disorders (eISSN: 2207-3744) is a peer-reviewed, online-only, open-access journal that publishes basic science and clinical research articles on disorders of the kidneys and the liver. In addition to considering disorders of each organ separately, the journal aims to be a scholarly forum for discussing how disorders of one organ influence the other. Chronic liver disease is associated with primary and secondary kidney diseases. Similarly, renal disorders are associated with hepatic disorders. Original articles, reviews, and case reports on any aspects of nephrology and hepatology are suitable for submission.</p> <p><strong>Now Indexed in EMBASE (Elsevier), Excerpta Medica</strong></p> <p>&nbsp;</p> Codon Publications en-US Journal of Renal and Hepatic Disorders 2207-3744 <p>Authors who publish with this journal agree to the following terms:</p><ul><li>Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a <a title="License" href="" target="_blank">Creative Commons Attribution License</a> that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.</li><li>Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</li></ul>Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See <a href="" target="_new">The Effect of Open Access</a> Paradigm shift in Etiology of Upper Gastrointestinal Bleed in Emergency Department <p>Background and Aims: Acute upper gastrointestinal (UGI) bleed is an emergency requiring immediate intervention. Recent data have shown peptic ulcer disease (PUD) to be commonest cause of UGI bleed. We aimed to evaluate all patients of UGI bleed reporting in emergency department. Methods: A cross-sectional, observational study from a tertiary care centre and evaluated all patients with UGI bleed presenting to outpatient and emergency department between December 2017 and December 2018 conducted. Results: 356 patients with UGI bleed were undertaken for diagnostic and therapeutic endoscopy. Variceal bleed was present in 231 (65%) [cirrhosis 217(61%) vs non-cirrhotic 14 (4%)], non-variceal 93 (26%) [cirrhosis 22(6%) vs non-cirrhotic 71(20%)] and no cause determined in 32 (9%). Among cirrhotic patients, alcoholic liver disease (n=172) was most common followed by cryptogenic (n=32), HCV (n=22) and HBV (n=7) and AIH (n=6) related cirrhosis. Among variceal non-cirrhotic causes, non-cirrhotic portal hypertension was present in 14 patients. In non-cirrhotic non-variceal group, causes of UGI bleed included esophagitis (n=26), erosive gastritis (n=9) and Mallory Weiss Tear (n=7) followed by PUD (n=23), carcinoma stomach (n=3), carcinoma esophagus (n=2) and duodenal polyp (n=1). Non-variceal cirrhotic patients had portal hypertensive gastropathy (n=8), PUD (n=5), duodenal erosions (n=1), esophagitis (n=7), antral varix (n=1). Interestingly, even in non-variceal group, alcohol was the underlying cause of UGI bleed in majority of patients with esophagitis and erosive gastritis. Conclusion: Alcohol was the commonest cause of UGI bleed in majority of cases with or without chronic liver disease followed by PUD in small number in emergency department.</p> Tarana Gupta Sandeep Goyal Copyright (c) 2021 Tarana Gupta, Sandeep Goyal 2021-03-16 2021-03-16 5 1 14 18 10.15586/jrenhep.v5i1.93 Acute Alcohol Tissue Damage: Protective Properties of Betaine <p>Teenage binge drinking is a major health issue; however, there is a paucity of data on liver injury. Herein, we investigated how acute ethanol affects juvenile hepatic cells through changes in oxidative stress, apoptosis, and liver function, as well as the ability of betaine, which can replen-ish the antioxidant glutathione and mitigate oxidative injury. Juvenile male Wistar rats were given either water or betaine (2% w/v) for 6 days and treated with either saline 0.15 mol/L NaCl or ethanol (75 mmol/kg bodyweight). After 24 h, liver enzymes, oxidative damage, apoptosis, and parameters of antioxidant enzyme activity were examined. Acute ethanol increased hepatic enzymes (99%, P &lt; 0.05). Total protein and albumin levels were reduced by 14 and 18% (P &lt; 0.001), respectively, which was prevented by betaine treatment. Cytosolic cytochrome c increased by 59% (P &lt; 0.05), corresponding to a decrease in mitochondrial cytochrome c content, which was ameliorated with betaine. Cytosolic glutathione peroxidase was reduced with alcohol (P &lt; 0.05) and was prevented with betaine. Subtle changes were observed in catalase, superoxide dismutase, glutathione reductase, and complex I activity after ethanol treatment. In summary, whilst juvenile animals appear to have higher basal levels of antioxidant enzymes, betaine conferred some protection against alcohol-induced oxidative stress.</p> Lucy Petagine Hannah Everitt Victor Preedy Roy Sherwood Vinood Patel Copyright (c) 2021 Lucy Pentagine, Hannah Everitt, Victor Preedy, Roy Sherwood, Vinood Patel 2021-03-19 2021-03-19 5 1 19 29 10.15586/jrenhep.v5i1.96 The Indirect Implication of SARS-CoV-2 Resulting in Kayexalate Toxicity in a Patient with Acute Kidney Injury <p>The clinical features of corona virus disease 2019 (COVID-19) are variable, but the majority of patients experience mild flu-like symptoms. The cases of severe disease include complications such as progressive pneumonia, acute kidney injury, multi-organ failure, and even death. This paper explores the association between COVID-19 and its effect on multiple organ systems and how the subsequent treatment of this disease can itself lead to morbidity and mortality. We present a case which emphasizes the life threatening gastrointestinal complications associated with treatment of acute kidney injury (AKI) in a patient with COVID-19. We conclude that the patients whose treatment regimens utilize medical resins should be closely monitored for gastrointestinal complications so as to mitigate the known adverse effects associated with these drugs, such as colonic mucosal ulceration, perforation, or even death.</p> Charles E. Middleton IV William Daley Neha Varshney Copyright (c) 2021 Charles E. Middleton IV, William Daley, Neha Varshney 2021-02-27 2021-02-27 5 1 6 13 10.15586/jrenhep.v5i1.88 Mortality among Critically Ill Acute Kidney Injury Patients Stratified with RIFLE Classification <p>Acute kidney injury, also referred to as AKI, is a common complication seen in critically ill patients . There has been a significant increase in the number of AKI cases over the past few decades. In order to standardize the classification of AKI, the RIFLE (Risk, Injury, Failure, Loss, End-Stage) and AKIN (AKI Network) criteria were developed.<br />This is a prospective, observational, and longitudinal cohort study where data from all patients admitted to the hospital intensive care unit (ICU) were collected. The study duration ranged from March 2019 to September 2020. During the study period, 198 patients were admitted to the ICU. Of these, 69 were excluded while the remaining 104 patients were included in the study.<br />About 66–67% of the total critically ill patient population admitted in the ICU suffer from some etiology related to AKI. Our study highlights the aspect in which the cases of AKI are underreported. RIFLE class R or class I is still associated with excess mortality compared with patients who maintained normal function. RIFLE is a reliable system of classification, which is well classified and indicates the immediate necessity of renal replacement therapy (RRT); the prognosis of early RRT is fairly good in critically ill patients with AKI.</p> Jais Kumar Hassan Mumtaz Arsh Zahoor Naveed Sarwar Kishore Kumar Shahzaib Ahmad Copyright (c) 2021 Jais Kumar, Hassan Mumtaz, Arsh Zahoor, Naveed Sarwar, Kishore Kumar, Shahzaib Ahmad 2021-01-26 2021-01-26 5 1 1 5 10.15586/jrenhep.v5i1.89