Vasoconstrictors in hepatorenal syndrome - A critical review.
Ann Hepatol
; 18(2): 287-290, 2019.
Article
in En
| MEDLINE
| ID: mdl-31023616
ABSTRACT
Hepatorenal syndrome has the worst prognosis among causes of acute kidney injury in cirrhotic patients. Its definitive treatment is liver transplantation. Nevertheless, considering its high short-term mortality rate and the shortage of liver grafts, a pharmacological treatment is of utmost importance, serving as a bridge to liver transplant. The clinical management of hepatorenal syndrome is currently based on the use of a vasoconstrictor in association with albumin. Terlipressin, noradrenaline and the combination of midodrine and octreotide could be used to treat hepatorenal syndrome. Among these options, terlipressin seems to gather the strongest body of evidence regarding efficacy and should be considered the first line of treatment whenever available and in the absence of contraindications. Treatment with a vasoconstrictor and albumin should be promptly initiated after the diagnosis of hepatorenal syndrome in order for patients to have higher chances of recovery.
Key words
Full text:
1
Database:
MEDLINE
Main subject:
Splanchnic Circulation
/
Vasoconstriction
/
Vasoconstrictor Agents
/
Vasodilation
/
Hepatorenal Syndrome
/
Acute Kidney Injury
/
Liver Cirrhosis
Type of study:
Systematic_reviews
Limits:
Animals
/
Humans
Language:
En
Journal:
Ann Hepatol
Journal subject:
GASTROENTEROLOGIA
Year:
2019
Type:
Article