Decompensation of Cirrhosis and Iron Metabolism

  • STATUS
    Recruiting
  • End date
    Nov 27, 2022
  • participants needed
    100
  • sponsor
    Rennes University Hospital
Updated on 27 July 2021
hypertension
iron
ascites
hepatitis
encephalopathy
acute on chronic liver failure
gastric varices

Summary

Iron is a crucial metal whose metabolism is tightly regulated. Iron deficiency or iron overload are both deleterious at the cellular, organic and systemic levels. In line with the major role of the liver in iron homeostasis, links between iron metabolism and acute on chronic liver failure have been highlighted. Nevertheless, due to the difficulty of accurately assessing iron metabolism in this situation, therapeutic intervention on iron metabolism in this setting is currently not codified.

A better understanding of these mechanisms is therefore essential, in particular by characterizing the impact of exposure to non-transferrin-bound iron in acute on chronic liver failure on short-term mortality.

Overall, a better understanding of the physiopathological mechanisms of iron should allow to optimize the martial balance in this condition and also improve therapeutic approaches.

Details
Condition Cirrhosis, Fibrosis, Hepatic Fibrosis, hepatic cirrhosis, liver cirrhosis
Treatment blood sampling
Clinical Study IdentifierNCT04807023
SponsorRennes University Hospital
Last Modified on27 July 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

Age 18 years old
Diagnosis of cirrhosis, previously known or not, of any etiology, histologically proven or not
Hospitalization for acute on chronic liver failure
Ascites decompensation
Or spontaneous infection of the ascites fluid (defined as PNN > 250/mm3 of ascites)
Or digestive hemorrhage related to portal hypertension (digestive fibroscopy showing active bleeding or stigmas of recent bleeding from esophageal and/or gastric varices)
Or hepatic encephalopathy (clinically defined +/- increase in ammonia and/or by electroencephalogram and classified in stages according to West-Haven)
Or hepato-renal syndrome (HRS-AKI criteria, EASL 2018)
Or bacterial infection (defined by a bacteremia identified by at least one blood culture and/or an infectious site authenticated on imaging)
Or Acute Alcoholic Hepatitis (histologically proven or not)
Non-opposition of the patient, relative or legal representative

Exclusion Criteria

Treatment with oral or intravenous iron in the month prior to hospitalization
Implementation of a TIPS in the month prior to admission
Presence of hepatocellular carcinoma with an expected survival < 3 months or any other progressive cancer
Adult person subject to legal protection (safeguard of justice, curatorship, guardianship), person deprived of liberty
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