Details

Autor(en) / Beteiligte

• Singh, Virendra
• Ghosh, Souvik
• Singh, Baljinder
• Kumar, Pradeep
• Sharma, Navneet
• Bhalla, Ashish
• Sharma, A.K
• Choudhary, N.S
• Chawla, Yogesh
• Nain, C.K

Titel

Noradrenaline vs. terlipressin in the treatment of hepatorenal syndrome: A randomized study

Ist Teil von

• Journal of hepatology, 2012-06, Vol.56 (6), p.1293-1298

Ort / Verlag

Kidlington: Elsevier B.V

Erscheinungsjahr

2012

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Background & Aims Various vasoconstrictors are useful in the management of hepatorenal syndrome (HRS). Terlipressin is the drug of choice; however, it is expensive. In this study, we evaluated safety and efficacy of terlipressin and noradrenaline in the treatment of HRS. Methods Forty-six patients with HRS type 1 were managed with terlipressin (group A, N = 23) or noradrenaline (Group B, N = 23) with albumin in a randomized controlled trial at a tertiary center. Results HRS reversal could be achieved in 9 (39.1%) patients in group A and 10 (43.4%) patients in group B ( p = 0.764). Univariate analysis showed baseline Child Turcotte Pugh score (CTP), model of end stage liver disease (MELD), urine output on day 1(D1), albumin, and mean arterial pressure (MAP) were associated with response. However, on multivariate analysis only CTP score was associated with response. Fourteen patients in group A and 12 in group B died at day 15 ( p >0.05). Noradrenaline was less expensive than terlipressin ( p <0.05). No major adverse effects were seen. Conclusions The results of this randomized study suggest that noradrenaline is as safe and effective as terlipressin, but less expensive in the treatment of HRS and baseline CTP score is predictive of response.