A study on clinical outcomes of combination of terlipressin and albumin in Hepatorenal Syndrome

Scand J Gastroenterol. 2020 Jul;55(7):860-864. doi: 10.1080/00365521.2020.1786851. Epub 2020 Jul 7.

Abstract

Background: Hepatorenal Syndrome (HRS) is a reversible functional renal impairment that occurs in patients with advanced liver cirrhosis or those with fulminant hepatic failure.

Aim: To evaluate the effect of terlipressin and albumin combination in various clinical outcomes in Hepatorenal Syndrome patientsMethods and Material: It was a prospective study involving 50 patients with HRS. The effectiveness parameters of the treatments were: confirmed HRS reversal, Recurrence of HRS within 90 days of treatment and mortality rate up to 90 days. The safety assessment includes adverse events collected up to 14 days of post-treatment. The quality of life of HRS patients was assessed using SF-12 questionnaire.

Results: In the present study the mean age of patients was found to be 55.10 ± 9.35 years. Mean serum creatinine values were found to be reduced (1.22 ± 0.96) by 10th day in type 1 HRS which indicated improved renal function. Study patients showed a marked improvement in liver function throughout the observation period. 74% of patients did not have HRS recurrence and 79.48% of patients had completely relieved from HRS. Loose stool (14.2%) and hyponatremia (14.2%) were the prominent side effects of the therapy. The quality of life of patients also showed a statistically significant betterment in both physical and mental functioning.

Conclusions: Our study concluded that terlipressin and albumin combination was safe and effective in successfully stabilising cirrhosis patients with Hepatorenal Syndrome and bridging eligible patients to liver transplantation by restoring the liver and renal function with minimal adverse effects.

Keywords: Hepatorenal Syndrome; albumin; mortality; terlipressin.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Albumins / administration & dosage*
  • Drug Therapy, Combination
  • Female
  • Hepatorenal Syndrome / drug therapy*
  • Hepatorenal Syndrome / etiology
  • Humans
  • India
  • Kidney / drug effects
  • Kidney / physiopathology
  • Kidney Function Tests
  • Liver Cirrhosis / complications*
  • Male
  • Middle Aged
  • Prospective Studies
  • Quality of Life
  • Recurrence
  • Terlipressin / administration & dosage*
  • Tertiary Care Centers
  • Treatment Outcome
  • Vasoconstrictor Agents / administration & dosage*

Substances

  • Albumins
  • Vasoconstrictor Agents
  • Terlipressin