Respiratory events with terlipressin and albumin in hepatorenal syndrome: A review and clinical guidance.
albumin
hepatorenal syndrome
respiratory events
terlipressin
vasoconstrictor
Journal
Liver international : official journal of the International Association for the Study of the Liver
ISSN: 1478-3231
Titre abrégé: Liver Int
Pays: United States
ID NLM: 101160857
Informations de publication
Date de publication:
10 2022
10 2022
Historique:
revised:
06
07
2022
received:
18
02
2022
accepted:
12
07
2022
pubmed:
16
7
2022
medline:
1
9
2022
entrez:
15
7
2022
Statut:
ppublish
Résumé
Hepatorenal syndrome-acute kidney injury (HRS-AKI) is a serious complication of severe liver disease with a clinically poor prognosis. Supportive care using vasoconstrictors and intravenous albumin are the current mainstays of therapy. Terlipressin is an efficacious vasoconstrictor that has been used for 2 decades as the first-line treatment for HRS-AKI in Europe and has demonstrated greater efficacy in improving renal function compared to placebo and other vasoconstrictors. One of the challenges associated with terlipressin use is monitoring and mitigating serious adverse events, specifically adverse respiratory events, which were noted in a subset of patients in the recently published CONFIRM trial, the largest randomized trial examining terlipressin use for HRS-AKI. In this article, we review terlipressin's pharmacology, hypothesize how its mechanism contributes to the risk of respiratory compromise and propose strategies that will decrease the frequency of these events by rationally selecting patients at lower risk for these events.
Identifiants
pubmed: 35838488
doi: 10.1111/liv.15367
pmc: PMC9762017
mid: NIHMS1853854
doi:
Substances chimiques
Albumins
0
Vasoconstrictor Agents
0
Lypressin
50-57-7
Terlipressin
7Z5X49W53P
Types de publication
Journal Article
Review
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2124-2130Subventions
Organisme : NIDDK NIH HHS
ID : K23 DK128567
Pays : United States
Informations de copyright
© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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