Terlipressin and Albumin Combination Treatment in Patients with Hepatorenal Syndrome Type 2

Overview

Journal United European Gastroenterol J

Publisher Wiley

Specialty Gastroenterology

Date 2019 May 9

PMID 31065370

Citations 12

Authors

Marc Nguyen-Tat

Julia Jager

Johannes Wilhelm Rey

Michael Nagel

Christian Labenz

Marcus-Alexander Worns

Peter Robert Galle

Jens Uwe Marquardt

Affiliations

Soon will be listed here.

Abstract

Background: Hepatorenal syndrome (HRS) is associated with a poor prognosis. In HRS type 1, loss of renal function is rapidly progressive, while HRS type 2 is characterised by chronic ascites and more moderately elevated renal parameters. While treatment with terlipressin/albumin is well established in type 1, its effectiveness in chronic HRS is less clear.

Objective: The aim of this study was to evaluate the effectiveness of terlipressin/albumin treatment in patients with HRS type 2.

Methods: All patients with a first episode of HRS between April 2013 and February 2016 were included in this observational study. Relevant clinical and laboratory parameters were recorded and patients were followed.

Results: A total of 106 patients with HRS were included. With terlipressin therapy reversal of HRS types 1 and 2 was achieved in 48% and 46% of patients ( = 0.84) with relapse rates of 8% vs 50% ( = 0.001). Overall survival (OS) and survival free of liver transplantation (LTx) were similar in HRS types 1 and 2 ( = 0.69; = 0.64). In multivariate analysis response to treatment was independently associated with better OS in HRS type 2, in addition to established risk factors such as lower Model for End-Stage Liver Disease score, absence of hepatic encephalopathy and eligibility for LTx.

Conclusion: A terlipressin treatment course seems to be justified in selected patients with HRS type 2, especially in countries and settings with long transplant waiting lists. In addition treatment response might also help to identify HRS type 2 patients with a more favourable outcome.

Citing Articles

From past to present to future: Terlipressin and hepatorenal syndrome-acute kidney injury.

Allegretti A, Patidar K, Ma A, Cullaro G Hepatology. 2024; .

PMID: 38353565 PMC: 11322426. DOI: 10.1097/HEP.0000000000000790.

Novel predictors of response to therapy with terlipressin and albumin in hepatorenal syndrome-acute kidney injury.

Narayanan V, Devadas K, Sreesh S, Varghese J, Solanki R, Mohapatra S Ann Gastroenterol. 2024; 37(1):81-88.

PMID: 38223250 PMC: 10785019. DOI: 10.20524/aog.2023.0853.

Albumin, an interesting and functionally diverse protein, varies from 'native' to 'effective' (Review).

Wu N, Liu T, Tian M, Liu C, Ma S, Cao H Mol Med Rep. 2023; 29(2).

PMID: 38099350 PMC: 10784728. DOI: 10.3892/mmr.2023.13147.

Terlipressin for the Prevention and Treatment of Renal Decline in Hepatorenal Syndrome: A Drug Profile.

Ayyad A, Al-Horani R Gastroenterol Insights. 2023; 14(4):420-430.

PMID: 37873544 PMC: 10587779. DOI: 10.3390/gastroent14040031.

A Systematic Review of the Emerging Treatment for Hepatorenal Syndrome With a Principal Focus on Terlipressin: A Recent FDA-Approved Drug.

Thangaraj S, Srinivasan M, Arzoun H, Thomas S Cureus. 2023; 15(7):e42367.

PMID: 37621788 PMC: 10445509. DOI: 10.7759/cureus.42367.

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