Cargando…

Hepatorenal Syndrome: Outcome of Response to Therapy and Predictors of Survival

Aim. Treatment of hepatorenal syndrome (HRS) in patients with liver cirrhosis is still challenging and characterized by a very high mortality. This study aimed to delineate treatment patterns and clinical outcomes of patients with HRS intravenously treated with terlipressin. Methods. In this retrosp...

Descripción completa

Detalles Bibliográficos
Autores principales: Heidemann, Jan, Bartels, Christoph, Berssenbrügge, Christoph, Schmidt, Hartmut, Meister, Tobias
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4422997/
https://www.ncbi.nlm.nih.gov/pubmed/25983746
http://dx.doi.org/10.1155/2015/457613
_version_ 1782370134722084864
author Heidemann, Jan
Bartels, Christoph
Berssenbrügge, Christoph
Schmidt, Hartmut
Meister, Tobias
author_facet Heidemann, Jan
Bartels, Christoph
Berssenbrügge, Christoph
Schmidt, Hartmut
Meister, Tobias
author_sort Heidemann, Jan
collection PubMed
description Aim. Treatment of hepatorenal syndrome (HRS) in patients with liver cirrhosis is still challenging and characterized by a very high mortality. This study aimed to delineate treatment patterns and clinical outcomes of patients with HRS intravenously treated with terlipressin. Methods. In this retrospective single-center cohort study, 119 patients (median [IQR]; 56.50 [50.75–63.00] years of age) with HRS were included. All patients were treated with terlipressin and human albumin intravenously. Those with response to treatment (n = 65) were compared to the patient cohort without improvement (n = 54). Patient characteristics and clinical parameters (Child stage, ascites, hepatic encephalopathy, HRS type I/II, and initial MELD score) were retrieved. Univariate analysis of factors influencing the success of terlipressin therapy and Cox regression analysis of factors influencing survival was carried out. Results. One-month survival was significantly longer in the group of responders (p = 0.048). Cox regression analysis identified age [Hazard ratio, 95% confidence interval (CI); 1.05, 1.01–1.09, resp.], alcohol abuse [HR 3.05, 95% CI 1.11–8.38], duration of treatment [HR 0.92, 95% CI 0.88–0.96], and MELD score [HR 1.08, 95% CI 1.02–1.14] to be independent predictors of survival. Conclusions. Survival of HRS patients after treatment depends on age, etiology of liver disease, and the duration of treatment.
format Online
Article
Text
id pubmed-4422997
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher Hindawi Publishing Corporation
record_format MEDLINE/PubMed
spelling pubmed-44229972015-05-17 Hepatorenal Syndrome: Outcome of Response to Therapy and Predictors of Survival Heidemann, Jan Bartels, Christoph Berssenbrügge, Christoph Schmidt, Hartmut Meister, Tobias Gastroenterol Res Pract Clinical Study Aim. Treatment of hepatorenal syndrome (HRS) in patients with liver cirrhosis is still challenging and characterized by a very high mortality. This study aimed to delineate treatment patterns and clinical outcomes of patients with HRS intravenously treated with terlipressin. Methods. In this retrospective single-center cohort study, 119 patients (median [IQR]; 56.50 [50.75–63.00] years of age) with HRS were included. All patients were treated with terlipressin and human albumin intravenously. Those with response to treatment (n = 65) were compared to the patient cohort without improvement (n = 54). Patient characteristics and clinical parameters (Child stage, ascites, hepatic encephalopathy, HRS type I/II, and initial MELD score) were retrieved. Univariate analysis of factors influencing the success of terlipressin therapy and Cox regression analysis of factors influencing survival was carried out. Results. One-month survival was significantly longer in the group of responders (p = 0.048). Cox regression analysis identified age [Hazard ratio, 95% confidence interval (CI); 1.05, 1.01–1.09, resp.], alcohol abuse [HR 3.05, 95% CI 1.11–8.38], duration of treatment [HR 0.92, 95% CI 0.88–0.96], and MELD score [HR 1.08, 95% CI 1.02–1.14] to be independent predictors of survival. Conclusions. Survival of HRS patients after treatment depends on age, etiology of liver disease, and the duration of treatment. Hindawi Publishing Corporation 2015 2015-04-23 /pmc/articles/PMC4422997/ /pubmed/25983746 http://dx.doi.org/10.1155/2015/457613 Text en Copyright © 2015 Jan Heidemann et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Heidemann, Jan
Bartels, Christoph
Berssenbrügge, Christoph
Schmidt, Hartmut
Meister, Tobias
Hepatorenal Syndrome: Outcome of Response to Therapy and Predictors of Survival
title Hepatorenal Syndrome: Outcome of Response to Therapy and Predictors of Survival
title_full Hepatorenal Syndrome: Outcome of Response to Therapy and Predictors of Survival
title_fullStr Hepatorenal Syndrome: Outcome of Response to Therapy and Predictors of Survival
title_full_unstemmed Hepatorenal Syndrome: Outcome of Response to Therapy and Predictors of Survival
title_short Hepatorenal Syndrome: Outcome of Response to Therapy and Predictors of Survival
title_sort hepatorenal syndrome: outcome of response to therapy and predictors of survival
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4422997/
https://www.ncbi.nlm.nih.gov/pubmed/25983746
http://dx.doi.org/10.1155/2015/457613
work_keys_str_mv AT heidemannjan hepatorenalsyndromeoutcomeofresponsetotherapyandpredictorsofsurvival
AT bartelschristoph hepatorenalsyndromeoutcomeofresponsetotherapyandpredictorsofsurvival
AT berssenbruggechristoph hepatorenalsyndromeoutcomeofresponsetotherapyandpredictorsofsurvival
AT schmidthartmut hepatorenalsyndromeoutcomeofresponsetotherapyandpredictorsofsurvival
AT meistertobias hepatorenalsyndromeoutcomeofresponsetotherapyandpredictorsofsurvival