Clinical ResearchTerlipressin in patients with cirrhosis and type 1 hepatorenal syndrome: A retrospective multicenter study☆,☆☆
Section snippets
Patients
This retrospective study included 99 patients with cirrhosis and type 1 HRS treated with terlipressin (Glypressine; Laboratoire Ferring SAS, Gentilly, France) admitted between April 1996 and April 2000 to 24 centers. All patients with HRS who had been treated with terlipressin in these centers were evaluated. To be included, patients were required to meet the following criteria: older than 18 years; diagnosis of HRS according to the International Ascites Club diagnosis criteria (i.e., low
Results
Fifty-five patients were enrolled in 5 large centers, and 44 patients were enrolled in 19 small centers. In 10 centers (including the 5 large centers), information was available on all the causes of renal failure in patients with cirrhosis admitted during the study period. In these 10 centers, 71 of 423 (17%) patients with cirrhosis and renal failure met the inclusion criteria. Three hundred fifty-two of 423 patients were excluded because of acute renal failure sensitive to plasma volume
Discussion
Although this was a retrospective study, it is the first investigation of the clinical course, predictive factors of improved renal function, and survival in a large series of patients with cirrhosis and type 1 HRS treated with terlipressin. At diagnosis of type 1 HRS before treatment, patients had severe cirrhosis, i.e., an increased Child–Pugh score and arterial hypotension.
In this study, the mean dose of terlipressin was 3 mg, and the mean duration of administration was 11 days. Terlipressin
Acknowledgements
The authors thank Patrick Blandin and Alain Truskolaski for their expert assistance.
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Address requests for reprints to: Richard Moreau, M.D., INSERM U-481, Hôpital Beaujon, 92118 Clichy, France. e-mail: [email protected]; fax: (33) 1-47-30-17-11.
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The study was supported by Ferring SAS (Gentilly, France).