Evidence map›Paper›PMID 26052400›Full record

ReviewWorld journal of hepatology2015

Adrenal insufficiency in patients with decompensated cirrhosis.

Apostolos Ka Karagiannis, Theodora Nakouti, Chrysoula Pipili, Evangelos Cholongitas

Open access · diamondAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in World journal of hepatology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 1 pooled it
2.5field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.

  1. Relative adrenal insufficiency in the non-critically ill patient with cirrhosis: A systematic review and meta-analysis.Liver international : official journal of the International Association for the Study of the Liver · 2023
    Pooled it
  2. Article
  3. Association of Hormonal Status With Sarcopenia, Frailty and Outcome in Patients With Decompensated Cirrhosis.Liver international : official journal of the International Association for the Study of the Liver · 2025
    Article
  4. Article
  5. Review
  6. Diagnosing and treating the elderly individual with hypopituitarism.Reviews in endocrine & metabolic disorders · 2024
    Review
  7. Review
  8. Hepatorenal Syndrome-Novel Insights into Diagnostics and Treatment.International journal of molecular sciences · 2023
    Review
  9. Overdiagnosis of adrenal insufficiency in children with biliary atresia.Clinical pediatric endocrinology : case reports and clinical investigations : official journal of the Japanese Society for Pediatric Endocrinology · 2023
    Article
  10. Article
  11. Review
  12. Review
  13. Acute-on-chronic liver failure: recent update.Journal of biomedical research · 2017
    Article
  14. Evaluation of Adrenal Function in Nonhospitalized Patients with Cirrhosis.Canadian journal of gastroenterology & hepatology · 2017
    Article
  15. Review
  16. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 3 countries.

Apostolos Ka KaragiannisApostolos KA Karagiannis, Department of Endocrinology, Diabetes and Metabolism, Korgialeneio Mpenakeio Hospital, 11526 Athens, Greece.
Theodora NakoutiApostolos KA Karagiannis, Department of Endocrinology, Diabetes and Metabolism, Korgialeneio Mpenakeio Hospital, 11526 Athens, Greece.
Chrysoula PipiliApostolos KA Karagiannis, Department of Endocrinology, Diabetes and Metabolism, Korgialeneio Mpenakeio Hospital, 11526 Athens, Greece.
Evangelos CholongitasApostolos KA Karagiannis, Department of Endocrinology, Diabetes and Metabolism, Korgialeneio Mpenakeio Hospital, 11526 Athens, Greece.
Edinburgh Royal Infirmary · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Adrenal reserve depletion and overstimulation of the hypothalamus-pituitary-adrenal (HPA) axis are causes for adrenal insufficiency (AI) in critically ill individuals. Cirrhosis is a predisposing condition for AI in cirrhotics as well. Both stable cirrhotics and liver transplant patients (early and later after transplantation) have been reported to present AI. The mechanisms leading to reduced cortisol production in cirrhotics are the combination of low cholesterol levels (the primary source of cortisol), the increased cytokines production that overstimulate and exhaust HPA axis and the destruction of adrenal glands due to coagulopathy. AI has been recorded in 10%-82% cirrhotics depending on the test used to evaluate adrenal function and in 9%-83% stable cirrhotics. The similarity of those proportions support the assumption that AI is an endogenous characteristic of liver disease. However, the lack of a gold standard method for AI assessment and the limitation of precise thresholds in cirrhotics make difficult the recording of the real prevalence of AI. This review aims to summarize the present data over AI in stable, critically ill cirrhotics and liver transplant recipients. Moreover, it provides information about the current knowledge in the used diagnostic tools and the possible effectiveness of corticosteroids administration in critically ill cirrhotics with AI.

Indexed as

Adrenal insufficiencyCirrhosisCorticosteroidCritically ill

Identifiers

PMID26052400
PMCPMC4450188
OpenAlexW2185013161

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.