Abstract | BACKGROUND AND AIM:
Terlipressin has been proposed to treat renal failure in patients with type 1 hepatorenal syndrome (HRS). However, the predictive factors for improved renal function and survival are unknown in patients with type 1 HRS treated with terlipressin. The aim of the present retrospective study was to investigate the predictive factors and prognosis of patients with type 1 HRS treated with terlipressin. METHODS: The clinical charts of 18 consecutive patients with cirrhosis and type 1 HRS treated with terlipressin were studied. The predictive factors for improved renal function and survival were identified using univariate analyses. RESULTS: Improved renal function, indicated by a significant decrease in serum creatinine (61 +/- 4%), occurred in 11 (60%) patients. The only predictive factor for improved renal function was a Child-Pugh's score < or =13 at the time of diagnosis of HRS (P = 0.02). Fifteen patients (83%) died at 45 days and the median survival was 24 days. Of the three patients who survived, two underwent successful orthotopic liver transplantation. Three predictive factors for survival were identified: absence of a precipitating factor for HRS (P = 0.012); improved renal function during terlipressin therapy (P = 0.05); and a dose of terlipressin > or =3 mg/day (P = 0.04). CONCLUSIONS: In patients with type 1 HRS treated with terlipressin, patients with improved renal function had less severe cirrhosis (Child-Pugh >10 but < or =13) than patients without. The predictive factors for survival were the absence of a precipitating factor for HRS, the terlipressin-induced improvement in renal function and a dose of terlipressin of at least 3 mg/day. These findings suggest that a randomized controlled trial investigating the effect of terlipressin on survival in patients with type 1 HRS should be performed.
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Authors | Isabelle Colle, François Durand, Fabienne Pessione, Emmanuel Rassiat, Jacques Bernuau, Eric Barrière, Didier Lebrec, Dominique-Charles Valla, Richard Moreau |
Journal | Journal of gastroenterology and hepatology
(J Gastroenterol Hepatol)
Vol. 17
Issue 8
Pg. 882-8
(Aug 2002)
ISSN: 0815-9319 [Print] Australia |
PMID | 12164964
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright 2002 Blackwell Publishing Asia Pty Ltd |
Chemical References |
- Vasoconstrictor Agents
- Lypressin
- Terlipressin
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Topics |
- Adult
- Female
- Hepatorenal Syndrome
(drug therapy, etiology, mortality)
- Humans
- Liver Cirrhosis
(complications, drug therapy, mortality)
- Lypressin
(analogs & derivatives, therapeutic use)
- Male
- Middle Aged
- Predictive Value of Tests
- Prognosis
- Retrospective Studies
- Severity of Illness Index
- Survival Rate
- Terlipressin
- Vasoconstrictor Agents
(therapeutic use)
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