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Safety and efficacy of terlipressin in acute-on-chronic liver failure with hepatorenal syndrome-acute kidney injury (HRS-AKI): a prospective cohort study.
Kulkarni, Anand V; Ravikumar, Sowmya Tirumalige; Tevethia, Harshvardhan; Premkumar, Madhumita; Kumar, Karan; Sharma, Mithun; Gupta, Rajesh; Rao, Padaki Nagaraja; Reddy, Duvvuru Nageshwar.
Afiliación
  • Kulkarni AV; Department of Hepatology and Liver Transplantation, Asian Institute of Gastroenterology, Hyderabad, India. anandvk90@gmail.com.
  • Ravikumar ST; Department of Hepatology and Liver Transplantation, Asian Institute of Gastroenterology, Hyderabad, India.
  • Tevethia H; Department of Hepatology and Liver Transplantation, Asian Institute of Gastroenterology, Hyderabad, India.
  • Premkumar M; Department of Hepatology, PGIMER, Chandigarh, India.
  • Kumar K; Department of Hepatology, Mahatma Gandhi Medical College and Research Institute, Jaipur, India.
  • Sharma M; Department of Hepatology and Liver Transplantation, Asian Institute of Gastroenterology, Hyderabad, India.
  • Gupta R; Department of Hepatology and Liver Transplantation, Asian Institute of Gastroenterology, Hyderabad, India.
  • Rao PN; Department of Hepatology and Liver Transplantation, Asian Institute of Gastroenterology, Hyderabad, India.
  • Reddy DN; Department of Hepatology and Liver Transplantation, Asian Institute of Gastroenterology, Hyderabad, India.
Sci Rep ; 12(1): 5503, 2022 04 01.
Article en En | MEDLINE | ID: mdl-35365736
Terlipressin with albumin, the recommended treatment for hepatorenal syndrome-acute kidney injury (HRS-AKI), is associated with adverse events. Furthermore, the course of AKI in patients with acute-on-chronic liver failure (ACLF) is unknown. We aimed to analyze the safety and efficacy of terlipressin infusion and AKI course in patients with ACLF. We prospectively enrolled consecutive adult patients with ACLF with HRS-AKI (satisfying EASL criteria) treated with terlipressin infusion between 14 October 2019 and 24 July 2020. The objectives were to assess the incidence of adverse events, response to terlipressin, course of HRS-AKI and predictors of mortality. A total of 116 patients were included. Twenty-one percent of patients developed adverse effects. Only 1/3rd of patients who developed adverse events were alive at day 90. Sixty-five percent of the patients responded to terlipressin. Nearly 22% developed recurrence of HRS, and 5.2% progressed to HRS-chronic kidney disease. TFS was 70.4% at day 30 and 57.8% at day 90. On multivariate stepwise Cox regression analysis terlipressin non-response (hazard ratio [HR], 3.49 [1.85-6.57]; P < 0.001) and MELD NA score (HR,1.12 [1.06-1.18]; P < 0.001) predicted mortality at day-90. Patients with ACLF who develop terlipressin related adverse events have dismal prognoses. Terlipressin non-response predicts mortality in patients with ACLF and HRS-AKI.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome Hepatorrenal / Lesión Renal Aguda / Insuficiencia Hepática Crónica Agudizada Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: Sci Rep Año: 2022 Tipo del documento: Article País de afiliación: India Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome Hepatorrenal / Lesión Renal Aguda / Insuficiencia Hepática Crónica Agudizada Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: Sci Rep Año: 2022 Tipo del documento: Article País de afiliación: India Pais de publicación: Reino Unido