A study of the effect of terlipressin with albumin vs only albumin in patients diagnosed with hepatorenal syndrome (HRS)

Vignesh Yeleshwaram; Virendra. C. Patil; Pranav Mehta; Avanti Damle; Shivamsh Kasireddy

doi:10.53730/ijhs.v6nS2.5736

Authors

Vignesh Yeleshwaram Resident, Department of Medicine, Krishna Institute of Medical Sciences Deemed to be university, Karad
Virendra. C. Patil Professor, Department of Medicine, Krishna Institute of Medical Sciences Deemed to be university, Karad
Pranav Mehta Resident, Department of Medicine, Krishna Institute of Medical Sciences Deemed to be university, Karad
Avanti Damle Resident, Department of Medicine, Krishna Institute of Medical Sciences Deemed to be university, Karad
Shivamsh Kasireddy Resident, Department of Medicine, Krishna Institute of Medical Sciences Deemed to be university, Karad

Keywords:

cirrhosis, hepatorenal failure, terlipressin, albumin

Abstract

Background: Hepatorenal syndrome (HRS) is a potentially reversible, functional renal failure that occurs in patients with advanced liver disease. HRS is generally characterized by increased serum creatinine, azotemia, reduced diuresis, increased urine osmolarity, and reduced urine sodium values without signs of organic kidney damage¹. AIM: The aim of the study is to investigate the efficacy, adverse effects, and outcomes of Terlipressin with Albumin vs. only Albumin in patients diagnosed with hepatorenal syndrome. Material and methods: A single centred hospital-based descriptive ,observational study was conducted in patients admitted with a diagnosis of hepatorenal syndrome for 18 months (October 2019 to March 2021). A total 80 cases were studied. Results: All the parameters including Total Bilirubin, SGPT ( Serum glutamate pyruvate transaminase ), INR ( Internationalised normalised ratio ) and Serum Albumin were found to be similar ion both the groups except except SGOT (p=0.002) which was found to be significantly lower in Terlipressin +Albumin treatment group (61.89±47.83) compared to only albumin .(96.80±109.30). Those who were treated with Terlipressin +Albumin showed significant decrease in serum creatinine. A significant decrease in serum creatinine was observed at Day 5 (1.73±1.49) from Day 1 (3.47±1.68) making a mean percentage decrease of 50.14%.

Downloads

Download data is not yet available.

References

Gines A , Escorsell A , Gines P et al. Incidence, predictivefactors, and prognosis of the hepatorenal syndrome incirrhosis with ascites . Gastroenterology 1993 ; 105 : 229 – 236 .

Arroyo V, Fernandez J, Gin?s P: Pathogenesis and treatment of hepatorenal syndrome. Semin Liver Dis 2008; 28:81-95

Angeli P, Merkel C: Pathogenesis and management of hepatorenal syndrome in patients with cirrhosis. J Hepatol 2008; 48:S93-103.

Shusterman B, Mchedishvili G, Rosner MH: Outcomes for hepatorenal syndrome and acute kidney injury in patients undergoing liver transplantation: A single center experience. Transplant Proc 2007; 39:1496-500.

Ortega R, Gines P, Uriz J, et al. Terlipressin therapy with and without albumin for patients with hepatorenal syndrome: results of a prospective, nonrandomized study. Hepatology 2002;36: 941–948.

Boyer TD, Sanyal AJ, Wong F, Frederick RT, Lake JR, O'Leary JG, Ganger D, Jamil K, Pappas SC; REVERSE Study Investigators. Terlipressin Plus Albumin Is More Effective Than Albumin Alone in Improving Renal Function in Patients With Cirrhosis and Hepatorenal Syndrome Type 1. Gastroenterology. 2016 Jun;150(7):1579-1589.e2.

Sanyal AJ, Boyer T, Garcia-Tsao G, Regenstein F, Rossaro L, Appenrodt B, Blei A, Gülberg V, Sigal S, Teuber P; Terlipressin Study Group. A randomized, prospective, double-blind, placebo-controlled trial of terlipressin for type 1 hepatorenal syndrome. Gastroenterology. 2008 May;134(5):1360-8.

Narahara Y, Kanazawa H, Sakamoto C, Maruyama H, Yokosuka O, Mochida S, Uemura M, Fukui H, Sumino Y, Matsuzaki Y, Masaki N, Kokubu S, Okita K. The efficacy and safety of terlipressin and albumin in patients with type 1 hepatorenal syndrome: a multicenter, open-label, explorative study. J Gastroenterol. 2012 Mar;47(3):313-20.

Cavallin M, Kamath PS, Merli M, Fasolato S, Toniutto P, Salerno F, Bernardi M, Romanelli RG, Colletta C, Salinas F, Di Giacomo A, Ridola L, Fornasiere E, Caraceni P, Morando F, Piano S, Gatta A, Angeli P; Italian Association for the Study of the Liver Study Group on Hepatorenal Syndrome. Terlipressin plus albumin versus midodrine and octreotide plus albumin in the treatment of hepatorenal syndrome: A randomized trial. Hepatology. 2015 Aug;62(2):567-74.

Martín-LM, Pépin MN, Guevara M, Díaz F, Torre A, Monescillo A, Soriano G, Terra C, Fábrega E, Arroyo V, Rodés J, Ginès P; TAHRS Investigators. Terlipressin and albumin vs albumin in patients with cirrhosis and hepatorenal syndrome: a randomized study. Gastroenterology. 2008 May;134(5):1352-9.