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Clinical course, predictive factors and prognosis in patients with cirrhosis and type 1 hepatorenal syndrome treated with Terlipressin: a retrospective analysis.

AbstractBACKGROUND 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.
AuthorsIsabelle Colle, François Durand, Fabienne Pessione, Emmanuel Rassiat, Jacques Bernuau, Eric Barrière, Didier Lebrec, Dominique-Charles Valla, Richard Moreau
JournalJournal of gastroenterology and hepatology (J Gastroenterol Hepatol) Vol. 17 Issue 8 Pg. 882-8 (Aug 2002) ISSN: 0815-9319 [Print] Australia
PMID12164964 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
CopyrightCopyright 2002 Blackwell Publishing Asia Pty Ltd
Chemical References
  • Vasoconstrictor Agents
  • Lypressin
  • Terlipressin
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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