Clinical medicine (London, England)
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Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide. NAFLD is defined by excess fat in the liver and has a multidirectional relationship with metabolic syndrome. ⋯ Patients with NAFLD are at risk of cardiovascular disease and cancer, and in a proportion of individuals, NAFLD is associated with liver damage. This article summarises the epidemiology of NAFLD, the clinical approach to risk-assessing patients and briefly outlines current and future management options.
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Acute-on-chronic liver failure (ACLF) is a recently recognised and defined syndrome seen in patients with liver cirrhosis and carries a high short-term mortality in excess of 15% at 28 days. ACLF is defined by organ failures (OFs) and is distinct from simple 'acute decompensation' (AD) of cirrhosis. OFs involve the liver, kidney, brain, coagulation, respiratory system and the circulation, and are defined by the European Association for the Study of the Liver Chronic Liver Failure Consortium (CLIF-C) OF score. ⋯ Unfortunately, to date, there is no known specific therapy for ACLF except for liver transplantation, so the treatment revolves around institution of early organ support. Most of the patients will have a clear prognosis between 3-7 days of hospitalisation. CLIF-C ACLF score is the best available prognostic score in patients with ACLF.