Terlipressin and Albumin in Patients with Cirrhosis and Type I Hepatorenal Syndrome.

Dig Dis Sci. 2007 Oct 16

Neri S, Pulvirenti D, Malaguarnera M, Cosimo BM, Bertino G, Ignaccolo L, Siringo S, Castellino P.

Department of Internal Medicine and Systemic Diseases, Liver Operative Unit, Catania University Polyclinic, Via S. Sofia 86 (edificio 29. I piano), Catania, 95123, Italy, sergio.neri4@tin.it.

Purpose: Hepatorenal syndrome (HRS) is a pre-renal-like dysfunction that generally onsets in cirrhotic patients presenting ascites. We investigated the improvement of renal function in subjects with hepatorenal syndrome after terlipressin administration and the survival times after this treatment.

Fifty-two patients affected by cirrhosis, with diagnosis of hepatorenal syndrome were treated with intravenous terlipressin plus albumin (group A) or with albumin alone (group B). Liver and renal function, plasma renin activity, and aldosterone plasma levels were monitored. Results: Patients from group A showed a significant improvement (p < 0.001) of renal function valued by creatinine rate compared with the results obtained in group B. The probability of survival was higher in the group A (p < 0.0001). Conclusions: Our results seem to confirm that the administration of terlipressin plus albumin improves renal function in patients with cirrhosis and type I HRS and that a reversal of hepatorenal syndrome is strongly associated with improved survival.