Management of hepatorenal syndrome and associated outcomes: a systematic reviews.

BACKGROUND: Hepatorenal syndrome (HRS), a multiorgan condition of acute kidney injury, is seen in advanced liver disease. This study aims to evaluate the current treatment for HRS. METHODS: The authors searched PubMed, Scopus and Google Scholar literature. After quality assessment, 31 studies were included in this review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology and the population, intervention, comparison and outcome scheme were used. We included human-controlled trials that evaluate the current treatment for HRS. Two authors independently screened articles for inclusion, extracted data and assessed the quality of included studies. RESULTS: This study investigated the studies conducted on the effects of different treatments on follow-up of HRS patients. We gathered 440 articles, so 31 articles remained in our study. Of which 24 articles were conducted on terlipressin versus placebo or other treatments (midodrine/octreotide, norepinephrine, etc) that showed the higher rate of HRS reversal was detected for terlipressin in 17 studies (10 of them were significant), 2 studies achieved an insignificant lower rate of the model for end-stage liver disease score for terlipressin, 15 studies showed a decreased mortality rate in the terlipressin group (4 of them were significant). CONCLUSION: This review showed that terlipressin has a significantly higher reversal rate of HRS than the other treatments. Even the results showed that terlipressin is more efficient than midodrine/octreotide and norepinephrine as a previous medication, in reverse HRS, increasing patient survival.

Efficacy and Safety of Turmeric Dietary Supplementation on Proteinuria in CKD: A Systematic Review and Meta-analysis of RCT.

The beneficial effects of oral turmeric extract on proteinuria levels have been investigated in several human and animal studies. We conducted a systematic review and meta-analysis to evaluate the significance of this new treatment in CKD patients for the first time. We searched ISI Web of Science, PubMed/Medline, Google Scholar, Scopus, SID, and Magiran until March 2021 to identify human-controlled trials that evaluated the effect of turmeric on proteinuria in chronic kidney disease patients. A total of six trials met the selection criteria and were reviewed in our study and four of them were included in the meta-analysis. In these studies, the results showed not only a significant decrease in the level of proteinuria of the trial groups, who had received curcumin but also a significant change in the level of proteinuria between the trial and control groups (SMD = -0.72, 95% CI: -1.10 to 0.35). The results of this meta-analysis demonstrates that turmeric/curcumin oral supplementation significantly improves urinary protein excretion in patients who suffer from chronic kidney diseases with proteinuria; thus, it can be considered as a potential treatment modality in this population.  DOI: 10.52547/ijkd.6772.