Hepatorenal Syndrome

Functional KIDNEY FAILURE in patients with liver disease, usually LIVER CIRRHOSIS or portal hypertension (HYPERTENSION, PORTAL), and in the absence of intrinsic renal disease or kidney abnormality. It is characterized by intense renal vasculature constriction, reduced renal blood flow, OLIGURIA, and sodium retention.

Also Known As:

Syndrome, Hepatorenal

Networked: 1118 relevant articles (116 outcomes, 119 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Fibrosis (Cirrhosis)
2.	Acute Kidney Injury (Acute Renal Failure)
3.	Ascites
4.	Peritonitis
5.	Hemorrhage

Experts

1.	Ginès, Pere: 32 articles (11/2021 - 03/2002)
2.	Arroyo, Vicente: 23 articles (11/2018 - 03/2002)
3.	Wong, Florence: 18 articles (01/2022 - 03/2003)
4.	Solà, Elsa: 12 articles (11/2021 - 08/2012)
5.	Angeli, Paolo: 11 articles (01/2021 - 12/2006)
6.	Bernardi, Mauro: 11 articles (10/2020 - 04/2008)
7.	Cárdenas, Andrés: 10 articles (10/2022 - 03/2002)
8.	Allegretti, Andrew S: 9 articles (10/2022 - 01/2017)
9.	Piano, Salvatore: 9 articles (01/2021 - 08/2011)
10.	Bendtsen, Flemming: 9 articles (10/2017 - 05/2005)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Hepatorenal Syndrome:

1.	TerlipressinIBA 05/01/2011 - "Finally, we understand its use associated to terlipressin seems to be the best treatment strategy for type I hepatorenal syndrome. " 10/01/2008 - "Studies suggest that terlipressin is effective in the treatment of hepatorenal syndrome (HRS). " 11/01/2009 - "Terlipressin has been shown to be effective in the management of hepatorenal syndrome. " 02/27/2004 - "Terlipressin and Gelatinepolysuccinat appear to be a safe and effective treatment of hepatorenal syndrome." 01/01/2023 - "Early treatment with terlipressin in patients with hepatorenal syndrome yields improved clinical outcomes in North American studies."
2.	AlbuminsIBA 12/01/2019 - "The aim of our study was to determine the effect of low dose albumin perfusion during SBP on mortality and prevention of hepatorenal syndrome (HRS) in cirrhotic patients. " 01/01/2017 - "We conducted sensitivity analyses of RCTs in which participants received albumin, subgroup analyses of participants with type 1 or type 2 hepatorenal syndrome, and Trial Sequential Analyses to control random errors. " 05/01/2021 - "The majority of specialists indicated using albumin at the recommended doses for hepatorenal syndrome (HRS-AKI, 86.4%) and for large volume paracentesis (LVP, 73.3%). " 01/01/2021 - "The role of volume expansion using intravenous albumin in the setting of hepatorenal syndrome has been an everlasting debate among clinicians. " 11/25/2015 - "This meta-analysis suggests a dose-response relationship between infused albumin and survival in patients with type 1 hepatorenal syndrome. "
3.	Vasoconstrictor AgentsIBA 09/01/2013 - "Various vasoconstrictors have shown promising results in the management of type 1 hepatorenal syndrome (HRS). " 06/01/2012 - "Various vasoconstrictors are useful in the management of hepatorenal syndrome (HRS). " 02/01/2018 - "Despite its impact, diagnosis and treatment of HRS remains challenging and this review aims to assess and compare the available vasoconstrictors used as first-line treatment for HRS. Areas covered: A literature review was undertaken on the use of vasoconstrictors in HRS, using PubMed/Medline database searches of: 'hepatorenal syndrome', 'HRS' and 'vasoconstrictor'. " 01/01/2015 - "The efficacy of vasoconstrictors in hepatorenal syndrome (HRS) is variable. " 01/01/2023 - "Previous studies using varying medication doses along with the "old" definition of hepatorenal syndrome (HRS type 1) rather than HRS-AKI means that there is still a need for future multicenter prospective studies further refining the risk-benefit ratio of vasoconstrictors for HRS-AKI patients. "
4.	Midodrine (Midon)FDA LinkGeneric 12/01/2021 - "Midodrine has shown promising results in the treatment of AKI-hepatorenal syndrome (HRS-AKI). " 10/01/2014 - "Midodrine has demonstrated usefulness in hepatorenal syndrome. " 04/01/2009 - "These data suggest that midodrine is not effective in preventing hepatorenal syndrome type 2 recurrence." 04/01/2009 - "Midodrine in the prevention of hepatorenal syndrome type 2 recurrence: a case-control study." 04/01/2009 - "The outcome of 10 patients with hepatorenal syndrome type 2 treated successfully with terlipressin and then with midodrine (7.5-12.5mg/tid) was compared with that of an historical control group of hepatorenal syndrome type 2 patients responders to treatment with terlipressin. "
5.	Norepinephrine (Noradrenaline)FDA LinkGeneric 12/01/2000 - "[Successful therapy of hepatorenal syndrome with norepinephrine]." 01/01/2021 - "Toward Norepinephrine as a First-Line Treatment for All Hospitalized Patients With Hepatorenal Syndrome." 01/01/2018 - "Noradrenaline for reverting hepatorenal syndrome: a prospective, observational, single-center study." 01/01/2018 - "To evaluate the effectiveness of noradrenaline for the treatment of hepatorenal syndrome (HRS). " 12/12/2017 - "Concentration-dependent vasoconstriction induced by noradrenaline was significantly decreased in the renal arteries of hepatorenal syndrome rat because of gradually decreased renal blood flow. "
6.	Octreotide (Sandostatin)FDA LinkGeneric 07/01/2003 - "Octreotide in hepatorenal syndrome: a randomized, double-blind, placebo-controlled, crossover study." 01/01/1999 - "Octreotide in the treatment of the hepatorenal syndrome in cirrhotic patients." 09/01/2005 - "Vasopressin, not octreotide, may be beneficial in the treatment of hepatorenal syndrome: a retrospective study." 11/01/2012 - "Noradrenalin versus the combination of midodrine and octreotide in patients with hepatorenal syndrome: randomized clinical trial." 04/01/2009 - "In hepatorenal syndrome, patients using midodrine with octreotide showed significant changes in systemic hemodynamics and improvements in renal perfusion. "
7.	Vasopressins (Vasopressin)IBA 06/01/2008 - "Vasopressin analogues in the treatment of hepatorenal syndrome and gastrointestinal haemorrhage." 01/01/2000 - "Some patients with hepatorenal syndrome are established with highest plasma vasopressin concentrations. " 06/01/1996 - "In patients with hepatorenal syndrome (HRS), 4-hr administration of a vasopressin analog has recently been shown to benefit renal blood flow and renal function. " 08/01/1999 - "The purpose of this study was to confirm earlier reports that low-dose vasopressin (LDVP) analogues promote urine output in patients with hepatorenal syndrome (HRS) and to check whether this mode of therapy could also be effective in renal shutdown due to nonhepatic conditions. " 07/01/2003 - "In recent years, the use of vasopressin analogues in the treatment of hepatorenal syndrome has become an effective therapeutic strategy leading to improved survival and often allowing the completion of liver transplantation. "
8.	Pentoxifylline (Trental)FDA LinkGeneric 01/01/2011 - "Pentoxifylline appears to be especially effective in ALD patients with renal dysfunction/hepatorenal syndrome. " 09/11/2013 - "The study may have been underpowered to detect a significant difference in incidence of hepatorenal syndrome, which was less frequent in the group receiving pentoxifylline. " 10/07/2009 - "Meta-analysis showed that pentoxifylline reduced the hepatic-related mortality due to hepatorenal syndrome (RR 0.40; 95% CI 0.22 to 0.71), but trial sequential analysis did not support this result. " 03/01/2018 - "Treatment of Type-1 Hepatorenal Syndrome with Pentoxifylline: A Randomized Placebo Controlled Clinical Trial." 07/01/2014 - "Pentoxifylline is an effective alternative reducing the occurrence of hepatorenal syndrome. "
9.	CreatinineIBA 01/01/2020 - "There was an improvement in serum creatinine (Cr) (at 24 h; p = 0.386) and increase in urine output (UO), especially in the hepatorenal syndrome subgroup (HRS-AKI). " 01/01/2022 - "Type 1 hepatorenal syndrome (HRS1) is renamed HRS-AKI, which is stage 2 AKI [doubling of baseline serum creatinine (sCr)] while fulfilling all other criteria of HRS1. " 12/01/2015 - "As compared with control patients, those with HE and CDI were more likely to have older age, increased serum creatinine level, hepatorenal syndrome (HRS), and more prior hospitalizations. " 12/01/2015 - "The presence of type 1 hepatorenal syndrome (HRS) has traditionally been defined by a set of stringent criteria based on serum creatinine levels. " 07/01/2015 - "He also developed an acute worsening in serum creatinine (1.17-7.0 mg/dL in 7 days) despite subsequent treatment for presumed hepatorenal syndrome (HRS). "
10.	OrnipressinIBA 12/01/1996 - "The current study does not confirm a potential role for ornipressin in the treatment of hepatorenal syndrome." 01/01/1998 - "Although the prolonged administration of ornipressin combined with plasma volume expansion reverses hepatorenal syndrome, this treatment should be used with great caution in clinical practice because of the risk of ischemic complications." 01/01/1998 - "Reversibility of hepatorenal syndrome by prolonged administration of ornipressin and plasma volume expansion." 01/01/1995 - "Sustained effects of ornipressin in hepatorenal syndrome." 02/01/1994 - "Low-dose ornipressin improves renal function in the hepatorenal syndrome."

Therapies and Procedures

1.	Liver Transplantation 06/01/2013 - "Liver transplantation remains the best option for treating type-1 hepatorenal syndrome (HRS1). " 05/01/1997 - "However, patients can and do recover from the hepatorenal syndrome, but only if there is a significant improvement of their liver function, or if they undergo liver transplantation." 01/01/2021 - "Clinical Outcomes of Liver Transplantation in Patients With Hepatorenal Syndrome: A Single Center Study in China." 07/01/2012 - "This study investigated the outcomes of living donor liver transplantation (LDLT) for patients with preoperative type 1 hepatorenal syndrome (HRS) and acute hepatic decompensation. " 01/01/2023 - "The serum sST2 level in recipients with hepatorenal syndrome was higher than that in liver-transplant recipients without hepatorenal syndrome (P = 0.003). "
2.	Transjugular Intrahepatic Portasystemic Shunt 01/01/2020 - "There were significantly greater incidences of coagulopathy (83.9% vs 72.8%; P < .001), diabetes (45.5% vs 38.8%; P < .001), and hepatorenal syndrome (15.3% vs 12.5%; P < .001) in TIPS recipients vs those without a TIPS. " 01/01/2022 - "Transjugular intrahepatic porto-systemic shunt (TIPS) ameliorates renal function in type-2 hepatorenal syndrome (HRS). " 11/01/2020 - "It has been reported that transjugular intrahepatic portosystemic shunting (TIPS) might be utilized as a salvage option for hepatorenal syndrome (HRS), while randomized controlled trials are pending and real-world contemporary data on inpatient mortality is lacking. " 01/01/2020 - "In contrast, the role of TIPS in the hepatorenal syndrome has not been precisely defined. " 01/01/2019 - "Within the first month after TIPS placement, 34/63 (53.9%) patients developed clinically significant HE, which was associated with the baseline presence of type 2 hepatorenal syndrome (P=0.022). "
3.	Therapeutics 01/01/2008 - "Towards goal-directed therapy of hepatorenal syndrome: we have the tools but we need the trials." 01/01/2022 - "Hepatorenal Syndrome Type 1: From Diagnosis Ascertainment to Goal-Oriented Pharmacologic Therapy." 01/01/2021 - "These data may inform prognosis and discussions surrounding treatment options when patients with hepatorenal syndrome need chronic maintenance dialysis therapy." 01/01/2020 - "Predictors of response to type-1 hepatorenal syndrome (HRS) therapy are urgently needed. " 02/01/2018 - "Hepatorenal syndrome: the clinical impact of vasoactive therapy."
4.	Transplantation 08/25/2020 - "The treatment of systemic vasoconstrictors for hepatorenal syndrome proved to be effective in our study and should be the first priority for treating hepatorenal syndrome especially in places like Pakistan where liver transplantation is not that easily available." 11/01/2015 - "Treatment of type 2 hepatorenal syndrome in patients awaiting transplantation: Effects on kidney function and transplantation outcomes." 03/01/2015 - "However, the rate of hepatorenal syndrome (HRS) reversal and factors predicting renal outcomes after transplantation have not been fully elucidated. " 08/01/2006 - "For patients with hepatorenal syndrome, CLKT did not confer a survival advantage over liver-only transplantation (1-year patient survival was 72% vs 66%; P = .88). " 01/01/2004 - "Patients with hepatorenal syndrome (HRS) have a poor outcome after LTx compared with patients transplanted without HRS. To analyze the impact of treatment of HRS before LTx on outcome after transplantation. "
5.	Surgical Portasystemic Shunt (Portosystemic Shunt) 02/01/2020 - "Gender Disparity in Inpatient Mortality After Transjugular Intrahepatic Portosystemic Shunt Creation in Patients Admitted With Hepatorenal Syndrome: A Nationwide Study." 11/01/2020 - "Transjugular Intrahepatic Portosystemic Shunts for Hepatorenal Syndrome: TIPping the Scales in Whose Favor?" 11/01/2020 - "Inpatient Mortality Benefit with Transjugular Intrahepatic Portosystemic Shunt for Hospitalized Hepatorenal Syndrome Patients." 04/01/2018 - "The pooled rate of renal function improvement after transjugular intrahepatic portosystemic shunt was 93% in type 1 hepatorenal syndrome and 83% in any type of hepatorenal syndrome. " 04/01/2018 - "Nine publications were included, in which 128 patients with hepatorenal syndrome were treated with transjugular intrahepatic portosystemic shunt. "