| Terlipressin improves renal function in patients with cirrhosis and ascites without hepatorenal syndrome. | |
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MedLine Citation:
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PMID: 18027874 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Patients with advanced cirrhosis and ascites are characterized by circulatory dysfunction with splanchnic vasodilatation and renal vasoconstriction, which often lead to ascites. The vasoconstrictor terlipressin improves renal function in hepatorenal syndrome (HRS). The aim of this study was to evaluate if terlipressin also improves renal function in patients with ascites without HRS. Twenty-three patients with cirrhosis participated; 15 with nonrefractory ascites were randomized to either terlipressin (N group, n = 11) or a placebo (P group, n = 4), and 8 had refractory ascites and received terlipressin (R group). The glomerular filtration rate (GFR), sodium clearance (C(Na)), lithium clearance (C(Li)), osmolal clearance (C(Osm)), and urine sodium concentration (U(Na)) were assessed before and after the injection of 2 mg of terlipressin or the placebo. GFR increased in the N group (69 +/- 19 versus 92 +/- 25 mL/min, P < 0.005) and in the R group (31 +/- 19 versus 41 +/- 31 mL/min, P < 0.05) after terlipressin. In the N group, terlipressin induced an increase in C(Na) (0.89 +/- 0.21 versus 1.52 +/- 1.45 mL/min, P < 0.05), C(Li) (17.3 +/- 8.9 versus 21.5 +/- 11.6 mL/min, P < 0.05), and C(Osm) (2.10 +/- 0.81 versus 3.06 +/- 2.0 mL/min, P < 0.05). In the R group, terlipressin induced an increase in C(Na) (0.11 +/- 0.18 versus 0.35 +/- 0.40 mL/min, P < 0.05) and C(Li) (5.5 +/- 4.2 versus 9.5 +/- 8.55 mL/min, P < 0.05). U(Na) increased in both groups after terlipressin (P < 0.005). Plasma norepinephrine (P < 0.05) and renin (P < 0.05) decreased after terlipressin. All parameters remained unchanged after the placebo. Conclusion: The vasopressin 1 receptor agonist terlipressin improves renal function and induces natriuresis in patients with cirrhosis and ascites without HRS. Vasoconstrictors may represent a novel future treatment modality for these patients. |
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Authors:
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Aleksander Krag; Søren Møller; Jens H Henriksen; Niels-Henrik Holstein-Rathlou; Fin Stolze Larsen; Flemming Bendtsen |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Hepatology (Baltimore, Md.) Volume: 46 ISSN: 1527-3350 ISO Abbreviation: Hepatology Publication Date: 2007 Dec |
Date Detail:
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Created Date: 2007-12-06 Completed Date: 2008-01-10 Revised Date: 2009-11-19 |
Medline Journal Info:
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Nlm Unique ID: 8302946 Medline TA: Hepatology Country: United States |
Other Details:
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Languages: eng Pagination: 1863-71 Citation Subset: IM |
Affiliation:
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Department of Gastroenterology, Hvidovre Hospital, Denmark. aleksander.krag@hvh.regionh.dk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Ascites
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etiology Double-Blind Method Female Glomerular Filtration Rate / drug effects Hepatorenal Syndrome Humans Kidney / blood supply, drug effects, physiopathology* Kidney Diseases / drug therapy*, etiology Liver Cirrhosis, Alcoholic / complications* Lypressin / analogs & derivatives*, pharmacology, therapeutic use Male Middle Aged Receptors, Vasopressin / drug effects Recovery of Function Vasoconstrictor Agents / pharmacology, therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Receptors, Vasopressin; 0/Vasoconstrictor Agents; 14636-12-5/terlipressin; 50-57-7/Lypressin |
| Comments/Corrections | |
Comment In:
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Hepatology. 2007 Dec;46(6):1685-7
[PMID:
18046716
]
Hepatology. 2008 Aug;48(2):686 [PMID: 18666233 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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