Terlipressin for hepatorenal syndrome.

Journal

Current opinion in gastroenterology

ISSN: 1531-7056

Titre abrégé: Curr Opin Gastroenterol

Pays: United States

ID NLM: 8506887

Informations de publication

Date de publication:
15 Feb 2024

Historique:

medline: 14 2 2024

pubmed: 14 2 2024

entrez: 14 2 2024

Statut: aheadofprint

Résumé

The definition and diagnostic criteria of hepatorenal syndrome-acute kidney injury (HRS-AKI) has undergone recent changes. A major vasoconstrictor, terlipressin, has recently been approved as pharmacotherapy for HRS-AKI in the United States. The purpose of this review is to familiarize the readers with these new diagnostic criteria of HRS-AKI, and how best to use terlipressin. Terlipressin is effective either as bolus dosing or continuous infusion and can achieve reversal of HRS-AKI in approximately 40% of patients. Continuous infusion allows lower daily dose with equal efficacy and less side effects but not an approved mode of administration in the United States. Response to terlipressin in the randomized controlled trials was defined as repeat reduction of serum creatinine to less than 1.5 mg/dl. Newer studies will likely require response to treatment to be defined as a repeat serum creatinine to be less than 0.3 mg/dl from baseline. Terlipressin use is associated with ischemic side effects and potential for respiratory failure development. Careful patient selection and close monitoring are necessary for its use. Response to terlipressin with HRS-AKI reversal is associated with improved outcomes with better survival and less requirement for renal replacement therapy.

Identifiants

DOI: 10.1097/MOG.0000000000001016 PMID: 38353275

pubmed: 38353275

doi: 10.1097/MOG.0000000000001016

pii: 00001574-990000000-00124

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Informations de copyright

Références

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