Multisystem hemodynamic effects of terlipressin in cirrhosis

Introduction: Hepatorenal syndrome (HRS-AKI) is a serious complication of advanced liver disease. Pharmacologic options are limited in effectiveness, therefore liver transplantation is the definitive therapy. Early investigation into terlipressin as a first-line therapy for HRS-AKI has been promising but expected hemodynamic changes across organ systems in patients with cirrhosis have not been …

Safety and efficacy of continuous terlipressin infusion in HRS-AKI in a trans…

Hepatorenal syndrome-acute kidney injury (HRS-AKI) is associated with significant morbidity and mortality. While liver transplantation is the definitive treatment, continuous terlipressin infusion for HRS-AKI may provide benefit and, as such, was assessed in a population composed of candidates for liver transplant (LT). Fifty hospitalized LT-eligible patients with HRS-AKI received a single bolu…

Effectiveness and safety evaluation of terlipressin in the treatment of intes…

The study was divided into two phases, in the exploratory phase, we retrospectively analyzed the clinical data of patients with intestinal paralysis treated with low-dose terlipressin and explored its efficacy. In the clinical research phase, we designed a prospective cohort study, patients with intestinal paralysis were categorized into terlipressin treatment group (low-dose terlipressin was …

Comparative efficacy of terlipressin and norepinephrine for treatment of hepa…

The treatment of choice for hepatorenal syndrome-acute kidney injury (HRS-AKI) is vasoconstrictor therapy in combination with albumin, preferably norepinephrine or terlipressin as recommended by recent guidelines. In the absence of larger head-to-head trials comparing the efficacy of terlipressin and norepinephrine, meta-analysis of smaller studies can provide insights needed to understand the …

Pathophysiology, Diagnosis and Clinical Management of Hepatorenal Syndrome: F…

Advanced cirrhosis is frequently associated with renal dysfunction. Hepatorenal syndrome (HRS) is characterized by the occurrence of kidney injury in cirrhotic patients in the absence of other identifiable causes. HRS is classified in 2 different types. Type 1 is characterized by acute renal failure and rapid functional deterioration of other organs, usually related to a precipitating event.…

Hepatorenal syndrome: current concepts related to diagnosis and management

Renal failure in cirrhotic patients is a very severe condition. Hepatorenal syndrome has the worst prognosis among all causes of kidney failure in such patients. Hepatorenal syndrome is diagnosed especially in cirrhotic patients with ascites who develop loss renal function, despite diuretic suspension and volume expansion with albumin and for whom other causes of kidney injury have been exclude…

News in pathophysiology, definition and classification of hepatorenal syndrom…

Renal dysfunction is a common, life-threatening complication occurring in patients with liver disease. Hepatorenal syndrome (HRS) has been defined as a purely ‘‘functional” type of renal failure that often occurs in patients with cirrhosis in the setting of marked abnormalities in arterial circulation, as well as overactivity of the endogenous vasoactive systems.4,5 In 2007, the Internati…

Esophageal varices

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Esophageal varices

Esophageal varices are Porto-systemic collaterals — i.e., vascular channels that link the portal venous and the systemic venous circulation. They form as a consequence of portal hypertension (a progressive complication of cirrhosis), preferentially in the sub mucosa of the lower esophagus. Rupture and bleeding from esophageal varices are major complications of portal hypertension and are ass…

Hepatorenal syndrome: Update on diagnosis and treatment

Acute kidney injury (AKI) is a common complication in patients with end-stage liver disease and advanced cirrhosis regardless of the underlying cause. Hepatorenal syndrome (HRS), a functional form of kidney failure, is one of the many possible causes of AKI. HRS is potentially reversible but involves highly complex pathogenetic mechanisms and equally complex clinical and therapeutic management.…