Inside Scope

Welcome to our four-episode series: Raising Awareness of Hepatorenal Syndrome Acute Kidney Injury (HRS-AKI). In episode two, our host Muhamad Nadeem Yousaf, MD, speaks with Nikki Duong, MD, to discuss the nomenclature, pharmacological options, and care recommendations for HRS-AKI patients.

Each episode of this series corresponds to a journal article from a September 2023 supplement of Clinical Gastroenterology and Hepatology (CGH), the official clinical practice journal of the American Gastroenterological Association, focusing on addressing knowledge gaps in HRS-AKI.

To read the related journal articles and claim CME for listening, visit agau.gastro.org.

This series is supported by an independent educational grant from Mallinckrodt

Welcome to our four-episode series: Raising Awareness of Hepatorenal Syndrome Acute Kidney Injury (HRS-AKI). In our final episode, our host Muhamad Nadeem Yousaf, MD, speaks with Vivian Ortiz, MD, and Neil Shah, MD, to delve into critical aspects of HRS-AKI. They cover the prognosis after initial management, the significance of reversing renal impairment for liver transplant candidates, the predictive role of MELD score in HRS-AKI, treatment's impact on liver transplant waiting lists, decision-making between liver transplant alone or simultaneous liver-kidney transplant, timing considerations for kidney transplant post-liver transplant, and factors affecting post-transplant prognosis.

Each episode of this series corresponds to a journal article from a September 2023 supplement of Clinical Gastroenterology and Hepatology (CGH), the official clinical practice journal of the American Gastroenterological Association, focusing on addressing knowledge gaps in HRS-AKI.

To read the related journal articles and claim CME for listening, visit agau.gastro.org.

This series is supported by an independent educational grant from Mallinckrodt

Welcome to our four-episode series: Raising Awareness of Hepatorenal Syndrome Acute Kidney Injury (HRS-AKI). In episode three, our host Muhamad Nadeem Yousaf, MD, speaks with Nikhilesh Mazumder, MD, MPH, Shilpa Junna, MD, and Pratima Sharma, MD, MBBS, MS, to discuss initial management of patients with HRS-AKI. They’ll explore topics such as the efficacy of non-selective beta-blockers, the recommended plasma expander for those with decompensated cirrhosis, the roles of renal replacement therapy (RRT), TIPS, and extracorporeal liver support system (ELSS), and the significance of liver transplant in the context of HRS-AKI.

Each episode of this series corresponds to a journal article from a September 2023 supplement of Clinical Gastroenterology and Hepatology (CGH), the official clinical practice journal of the American Gastroenterological Association, focusing on addressing knowledge gaps in HRS-AKI.

To read the related journal articles and claim CME for listening, visit agau.gastro.org.

This series is supported by an independent educational grant from Mallinckrodt

Dr. G.S. Raju, editor of the Gastro Grand Rounds section in Gastroenterology, is joined by Drs. Marwan Ghabril and Naga Chalasani to discuss their Gastro Grand Rounds article, "A 68-Year-Old Woman With Unexplained Liver Enzyme Elevation and Active Chronic Hepatitis: Beware of Drug-Induced Autoimmune-Like Hepatitis." https://www.gastrojournal.org/article/S0016-5085(23)05078-3/fulltext

Dr. Ghabril is a professor of medicine at Indiana University School of Medicine. Dr. Chalasani is the David W. Crabb professor of gastroenterology and hepatology and an adjunct professor of anatomy, cell biology, and physiology at Indiana University School of Medicine.

[0:27] Introduction of the authors and outline of the case.

[3:30] Initial thoughts from the authors upon patient presentation.

[7:29] After considering additional patient history, what do the authors think about the patient?

[10:34] Does the family history of the patient cause the authors to refine the diagnosis?

[11:52] Further thoughts from the authors after physical examination of the patient.

[14:47] What tests are recommended?

[18:55] Additional thoughts from the authors after further testing.

[21:06] Should we be testing for hepatitis E?

[22:56] Should noninvasive testing be used?

[25:11] What is the authors' plan to determine next steps?

[27:06] How long should the wait be before a biopsy?

[29:08] The patient underwent liver biopsy. How were the results interpreted?

[34:31] How long does it take to determine that an appropriate course of action was made?

[35:37] How is the patient counselled?

[38:43] The LiverTox database.

[41:41] Final thoughts from the authors.

Thank you for listening. Find this and other articles on our website at https://www.gastrojournal.org. We welcome your feedback. Please email us at [email protected].

This discussion was recorded on Dec. 20, 2023, and reflects medical knowledge at that time. The views and opinions expressed in this podcast are those of the individual speakers only and do not necessarily represent those of the American Gastroenterological Association. The content of this podcast is provided for general information purposes only and does not offer medical or any other type of professional advice.

Welcome to our six-part series: Increasing Diversity in IBD Clinical Trials. This program will explore how to become a clinical trialist and increase diversity in IBD clinical trials.

In this episode, co-host Dr. Ayanna Lewis is joined by guest Dr. Erica Cohen, an adult gastroenterologist, IBD specialist and director of the IBD Research Program at Capital Digestive Care in Washington, D.C. Today’s discussion focuses on the community GI’s perspective on clinical trials.

This series is supported by educational grants from AbbVie Inc.; Amgen; Bristol-Myers Squibb Company; Genentech, a member of the Roche Group; Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC; and Takeda Pharmaceuticals U.S.A., Inc., and a quality improvement grant from Pfizer Inc.

Welcome to our six-part series: Increasing Diversity in IBD Clinical Trials. This program will explore how to become a clinical trialist and increase diversity in IBD clinical trials.

In this supersized episode, co-host Dr. Ayanna Lewis is joined by guest Dr. Ryan Stidham, an associate professor at the University of Michigan holding appointments in the departments of medicine and computational medicine. Dr. Stidham is a medical data scientist and has a research program that focuses on the development and testing of new technologies for disease assessment and decision making in gastroenterology and general medicine. Today’s discussion will explore how artificial intelligence may help address challenges with participant recruitment for clinical trials, while also discussing the role of AI in the field of gastroenterology more broadly.

This series is supported by educational grants from AbbVie Inc.; Amgen; Bristol-Myers Squibb Company; Genentech, a member of the Roche Group; Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC; and Takeda Pharmaceuticals U.S.A., Inc., and a quality improvement grant from Pfizer Inc.

Welcome to our six-part series: Increasing Diversity in IBD Clinical Trials. This program will explore how to become a clinical trialist and increase diversity in IBD clinical trials.

In this episode, co-host Dr. Erin Forster is joined by guest Kenneth Getz, professor of public health and community medicine and director of the Center for the Study of Drug Development at Tufts University School of Medicine. Ken is also the founder and chairman of the board of directors at CISCRP, a nonprofit dedicated to providing education and information about clinical research. Today's discussion will explore how we can bring awareness of and education on clinical research to the community.

This series is supported by educational grants from AbbVie Inc.; Amgen; Bristol-Myers Squibb Company; Genentech, a member of the Roche Group; Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC; and Takeda Pharmaceuticals U.S.A., Inc., and a quality improvement grant from Pfizer Inc.

Welcome to our six-part series: Increasing Diversity in IBD Clinical Trials. This program will explore how to become a clinical trialist and increase diversity in IBD clinical trials.

In this episode, hosts Drs. Erin Forster and Ayanna Lewis are joined by Melodie Narain-Blackwell, the founder and president of Color of Crohn’s & Chronic Illness (COCCI). COCCI is a nonprofit dedicated to health equity in BIPOC communities that are challenged with digestive diseases and chronic illnesses. Melodie was diagnosed with Crohn’s disease at the age of 36, thirty years after her symptoms began, and has become a passionate health advocate for people of color who battle chronic illness. Today’s discussion focuses on how we talk about clinical research with patients.

This series is supported by educational grants from AbbVie Inc.; Amgen; Bristol-Myers Squibb Company; Genentech, a member of the Roche Group; Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC; and Takeda Pharmaceuticals U.S.A., Inc., and a quality improvement grant from Pfizer Inc.

Welcome to our six-part series: Increasing Diversity in IBD Clinical Trials. This program will explore how to become a clinical trialist and increase diversity in IBD clinical trials.

In this episode, hosts Drs. Erin Forster and Ayanna Lewis are joined by Drs. Freddy Caldera and Jana Al Hashash, who were part of the inaugural class of participants in AGA’s GI Clinical Trialists Bootcamp program. Today’s discussion focuses on how diversifying participation in clinical trials starts with diversifying our workforce.

This series is supported by educational grants from AbbVie Inc.; Amgen; Bristol-Myers Squibb Company; Genentech, a member of the Roche Group; Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC; and Takeda Pharmaceuticals U.S.A., Inc., and a quality improvement grant from Pfizer Inc.

Welcome to our six-part series: Increasing Diversity in IBD Clinical Trials. This program will explore how to become a clinical trialist and increase diversity in IBD clinical trials.

In this episode, co-host Dr. Erin Forster is joined by guest Dr. Gabriela Radulescu, vice president of medical research and development at Alimentiv, a contract research organization (CRO) specializing in gastroenterology trials. Dr. Radulescu has more than 20 years of experience working in the pharmaceutical industry across multiple functions, including medical affairs, drug safety and pharmacovigilance, clinical research, real world evidence, and patient support programs. At Alimentiv, Dr. Radulescu provides medical leadership for sponsored clinical trials, operational oversight for R&D projects, and medical input to the business development teams. Today’s discussion will explore how CROs are working with investigators and sponsors to increase the diversity of patients enrolling in clinical trials.

This series is supported by educational grants from AbbVie Inc.; Amgen; Bristol-Myers Squibb Company; Genentech, a member of the Roche Group; Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC; and Takeda Pharmaceuticals U.S.A., Inc., and a quality improvement grant from Pfizer Inc.