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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...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi Publishing Corporation
2015
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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 |
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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 |
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