INTRODUCTION: Type 1 hepatorenal syndrome (HRS) is a functional renal failure that complicates end-stage cirrhosis. The vasopressin analogue terlipressin has been associated with improved renal function in patients with type 1 HRS. AIM: To evaluate the effectiveness of an infusion of terlipressin plus albumin in reversing type 1 HRS, its tolerability, and its adverse effects. METHODS: Thirteen consecutive patients with cirrhosis and type 1 HRS were included in the study. All patients received terlipressin plus albumin as treatment for HRS. The patients were divided in two groups. Group 1 contained eight patients in whom HRS was reversed with treatment, who were classified as responders. Group 2 contained five patients who were nonresponders. RESULTS: Sixty-one percent of the patients who received terlipressin plus albumin responded to therapy and underwent HRS reversal. In two patients, treatment with terlipressin was stopped because of adverse events. No relapse of HRS after terlipressin withdrawal was observed in this study. CONCLUSION: The rate of successful treatment with terlipressin plus albumin was 61%, similar to that in previously reported controlled trials. However, this is the first experience reported in Mexico. A cardiovascular evaluation is required before the start of treatment with terlipressin. This treatment appears to be an effective therapy for improving renal function in patients with type 1 HRS.
INTRODUCTION:Type 1 hepatorenal syndrome (HRS) is a functional renal failure that complicates end-stage cirrhosis. The vasopressin analogue terlipressin has been associated with improved renal function in patients with type 1 HRS. AIM: To evaluate the effectiveness of an infusion of terlipressin plus albumin in reversing type 1 HRS, its tolerability, and its adverse effects. METHODS: Thirteen consecutive patients with cirrhosis and type 1 HRS were included in the study. All patients received terlipressin plus albumin as treatment for HRS. The patients were divided in two groups. Group 1 contained eight patients in whom HRS was reversed with treatment, who were classified as responders. Group 2 contained five patients who were nonresponders. RESULTS: Sixty-one percent of the patients who received terlipressin plus albumin responded to therapy and underwent HRS reversal. In two patients, treatment with terlipressin was stopped because of adverse events. No relapse of HRS after terlipressin withdrawal was observed in this study. CONCLUSION: The rate of successful treatment with terlipressin plus albumin was 61%, similar to that in previously reported controlled trials. However, this is the first experience reported in Mexico. A cardiovascular evaluation is required before the start of treatment with terlipressin. This treatment appears to be an effective therapy for improving renal function in patients with type 1 HRS.
Authors: Ki Tae Suk; Soon Koo Baik; Jung Hwan Yoon; Jae Youn Cheong; Yong Han Paik; Chang Hyeong Lee; Young Seok Kim; Jin Woo Lee; Dong Joon Kim; Sung Won Cho; Seong Gyu Hwang; Joo Hyun Sohn; Moon Young Kim; Young Bae Kim; Jae Geun Kim; Yong Kyun Cho; Moon Seok Choi; Hyung Joon Kim; Hyun Woong Lee; Seung Up Kim; Ja Kyung Kim; Jin Young Choi; Dae Won Jun; Won Young Tak; Byung Seok Lee; Byoung Kuk Jang; Woo Jin Chung; Hong Soo Kim; Jae Young Jang; Soung Won Jeong; Sang Gyune Kim; Oh Sang Kwon; Young Kul Jung; Won Hyeok Choe; June Sung Lee; In Hee Kim; Jae Jun Shim; Gab Jin Cheon; Si Hyun Bae; Yeon Seok Seo; Dae Hee Choi; Se Jin Jang Journal: Korean J Hepatol Date: 2012-03-22