Hepatorenal syndrome and novel advances in its management

Kidney & Blood Pressure Research
F FabriziPiergiorgio Messa

Abstract

Hepatorenal syndrome is a complication of end stage liver disease. It is a unique form of functional renal failure related to kidney vasoconstriction in the absence of underlying kidney pathology. Hepatorenal syndrome is classified into 2 types: type-1 HRS shows a rapid and progressive decline in renal function with a very poor prognosis (median survival of about 2 weeks); type-2 HRS has a more stable kidney failure, with a median survival of 6 months; its main clinical manifestation is refractory ascites. The most appropriate therapy for HRS is liver transplantation but only a minority of HRS patients undergo the procedure due to the high mortality; survival among liver transplant recipients is lower in HRS than among their counterparts without HRS. A large body of evidence, based on observational studies and randomized controlled trials, has been accumulated in the last decade showing that terlipressin represents a milestone in the management of HRS. According to our meta-analysis of randomized trials comparing terlipressin vs. placebo (five trials, n=243 patients), the pooled rate of patients who reversed HRS by terlipressin was 8.09 (95% CI, 3.52; 18.59) (P<0.001). Among vasoconstrictors, terlipressin (a V1 vasopressin agon...Continue Reading

Citations

May 5, 2016·International Journal of Nephrology·Manish SunejaPhilip M Polgreen
Nov 27, 2018·Current Medical Research and Opinion·Jingqiao ZhangXingshun Qi
Sep 21, 2016·World Journal of Hepatology·Rohan M ModiKhalid Mumtaz
May 29, 2015·Diabetes·John D ClarkeNathan J Cherrington
Jul 12, 2018·BioMed Research International·Piyapon UtakoAbhasnee Sobhonslidsuk
Feb 6, 2021·Romanian Journal of Internal Medicine = Revue Roumaine De Médecine Interne·Irtiza HasanHani M Wadei
Aug 29, 2017·Kidney International·Andrew DavenportRajiv Jalan

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