Document Detail


Terlipressin in 30 patients with hepatorenal syndrome: results of a retrospective study.
MedLine Citation:
PMID:  19156588     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Terlipressin is known to improve renal function in patients with liver cirrhosis and hepatorenal syndrome (HRS). This study investigated effects of duration and dose of terlipressin therapy and predictive factors for positive response to treatment. The clinical charts of 30 consecutive patients with HRS who received terlipressin and albumin based on a determined therapeutic scheme, were retrospectively studied. In 25 (66 %) of 38 treatment episodes complete response was achieved (Kaplan-Meier survival method). Predictive for positive response to treatment were duration of treatment and cumulative terlipressin dosis (p < 0.01, 95 % CI 0.31 - 0.59 and p < 0.01, 95 % CI 0.93 - 0.98, respectively) as well as a low level of serum creatinine and MELD score at inclusion (p = 0.01, 95 % CI 0.3 - 9.85 and p < 0.01, 95 % CI 0.87 - 0.98 respectively) and HRS type II (p = 0.04, 95 % CI 1.04 - 9.93). The median duration of therapy was 6 days +/- 4.9 (SD) vs. 8 days +/- 6.3 in the nonresponder group. The median dose of terlipressin in the responder group was 3.9 mg +/- 1.3 per day vs. 3.4 mg +/- 1.4 in the nonresponder group (p = n. s.). The probability that complete response was obtained at day 17 of treatment was 84 % (95 % CI 0.64 - 0.96), whereas at day 7 it was just 52 % (95 % CI 0.36 - 0.7). In conclusion, these data confirm that terlipressin plus albumin is effective in two-thirds of patients with HRS. Prolongation of treatment beyond 7 days up to 20 days is capable of increasing the response rates. Whether outcome can be predicted depending on parameters like type of HRS and base-level of serum creatinine needs to be confirmed in further studies, especially with regard on the previously revised criteria of HRS.
Authors:
V von Kalckreuth; F Glowa; M Geibler; A W Lohse; U W Denzer
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Publication Detail:
Type:  Journal Article     Date:  2009-01-20
Journal Detail:
Title:  Zeitschrift für Gastroenterologie     Volume:  47     ISSN:  0044-2771     ISO Abbreviation:  Z Gastroenterol     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-21     Completed Date:  2009-03-23     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  0033370     Medline TA:  Z Gastroenterol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  21-6     Citation Subset:  IM    
Affiliation:
I. Department of Medicine, University Medical Center of Hamburg-Eppendorf, Hamburg, Germany. v.kalckreuth@uke.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Creatinine / blood
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Hepatorenal Syndrome / blood,  drug therapy*
Humans
Liver Cirrhosis / blood,  complications,  etiology
Liver Transplantation
Lypressin / administration & dosage,  adverse effects,  analogs & derivatives*
Male
Middle Aged
Prognosis
Renal Dialysis
Retrospective Studies
Vasoconstrictor Agents / administration & dosage*,  adverse effects
Chemical
Reg. No./Substance:
0/Vasoconstrictor Agents; 14636-12-5/terlipressin; 50-57-7/Lypressin; 60-27-5/Creatinine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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