Treatment variants in hepatorenal syndrome. Systematic review
DOI:
https://doi.org/10.56294/piii2024331Keywords:
Hepatorenal Syndrome, Treatments, Advances Cirrhosis, Ascites, Renal InsufficiencyAbstract
Introduction: hepatorenal syndrome (HRS) is a form of acute renal failure that occurs in patients with advanced cirrhosis and presents high mortality.
Objective: to describe the therapeutic alternatives in hepatorenal syndrome.
Methods: a search for information was carried out using the PubMed, TripDatabase and Cochrane databases; MeSH terms were used. Initially, 1749 articles were obtained; subsequently, 5 articles used in this systematic review were selected through the use of filters, review of titles, and elimination of duplicates.
Results: 548 patients were included. 325 patients received Terlipressin and 223 patients received Placebo. A reversal of SHR was evidenced in 35,8 % in patients receiving Terlipressin vs. 12,1 % placebo. Overall survival without liver transplantation was 36,7 % for the Terlipressin group and 21,1 % placebo. Adverse events were higher in the Terlipressin group.
Conclusion: Terlipressin is effective in improving renal function in patients with cirrhosis and hepatorenal syndrome type 1 (HRS-1). However, its use is associated with serious adverse events, such as respiratory failure. The combined treatment of terlipressin and albumin shows a greater improvement in renal function compared to the use of albumin alone. Further studies are needed to determine whether the improvement in renal function translates into a survival benefit for patients. Liver transplantation remains the most definitive treatment, and should be considered early in the course of the disease
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Copyright (c) 2024 Sebastián Emanuel Damasco, Aníbal Danilo Farias (Author)
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