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Treffer: Terlipressin and albumin combination treatment in patients with hepatorenal syndrome type 2.

Title:
Terlipressin and albumin combination treatment in patients with hepatorenal syndrome type 2.
Authors:
Nguyen-Tat M; First Department of Medicine, Cirrhosis Center Mainz (CCM), University Hospital Mainz, Mainz, Germany.; Department of Medicine II, Klinikum Osnabrück, Osnabrück, Germany., Jäger J; First Department of Medicine, Cirrhosis Center Mainz (CCM), University Hospital Mainz, Mainz, Germany., Rey JW; Department of Medicine II, Klinikum Osnabrück, Osnabrück, Germany., Nagel M; First Department of Medicine, Cirrhosis Center Mainz (CCM), University Hospital Mainz, Mainz, Germany., Labenz C; First Department of Medicine, Cirrhosis Center Mainz (CCM), University Hospital Mainz, Mainz, Germany., Wörns MA; First Department of Medicine, Cirrhosis Center Mainz (CCM), University Hospital Mainz, Mainz, Germany., Galle PR; First Department of Medicine, Cirrhosis Center Mainz (CCM), University Hospital Mainz, Mainz, Germany., Marquardt JU; First Department of Medicine, Cirrhosis Center Mainz (CCM), University Hospital Mainz, Mainz, Germany.
Source:
United European gastroenterology journal [United European Gastroenterol J] 2019 May; Vol. 7 (4), pp. 529-537. Date of Electronic Publication: 2019 Feb 20.
Publication Type:
Journal Article; Observational Study
Language:
English
Journal Info:
Publisher: Wiley Country of Publication: England NLM ID: 101606807 Publication Model: Print-Electronic Cited Medium: Print ISSN: 2050-6406 (Print) Linking ISSN: 20506406 NLM ISO Abbreviation: United European Gastroenterol J
Imprint Name(s):
Publication: 2021- : [London] : Wiley
Original Publication: London : Sage Publications, [2013]-
MeSH Terms:
Albumins/*therapeutic use , Hepatorenal Syndrome/*drug therapy , Liver Cirrhosis/*complications , Terlipressin/*therapeutic use , Vasoconstrictor Agents/*therapeutic use, Aged ; Drug Therapy, Combination/methods ; Female ; Follow-Up Studies ; Hepatorenal Syndrome/etiology ; Hepatorenal Syndrome/mortality ; Hepatorenal Syndrome/pathology ; Humans ; Kaplan-Meier Estimate ; Liver Cirrhosis/mortality ; Liver Cirrhosis/surgery ; Liver Transplantation/statistics & numerical data ; Male ; Middle Aged ; Recurrence ; Remission Induction/methods ; Treatment Outcome
References:
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Contributed Indexing:
Keywords: AKI; HRS; albumin; hepatorenal syndrome; liver cirrhosis; terlipressin
Molecular Sequence:
DRKS DRKS00013117
Substance Nomenclature:
0 (Albumins)
0 (Vasoconstrictor Agents)
7Z5X49W53P (Terlipressin)
Entry Date(s):
Date Created: 20190509 Date Completed: 20200508 Latest Revision: 20240717
Update Code:
20250114
PubMed Central ID:
PMC6488797
DOI:
10.1177/2050640619825719
PMID:
31065370
Database:
MEDLINE

Weitere Informationen

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 ( p  = 0.84) with relapse rates of 8% vs 50% ( p  = 0.001). Overall survival (OS) and survival free of liver transplantation (LTx) were similar in HRS types 1 and 2 ( p  = 0.69; p  = 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.