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...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2015/457613 |
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| author | Jan Heidemann Christoph Bartels Christoph Berssenbrügge Hartmut Schmidt Tobias Meister |
| author_facet | Jan Heidemann Christoph Bartels Christoph Berssenbrügge Hartmut Schmidt Tobias Meister |
| author_sort | Jan Heidemann |
| collection | DOAJ |
| 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 | Article |
| id | doaj-art-f453fbb9eaf149e2ada45a5bf30a5345 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
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| series | Gastroenterology Research and Practice |
| spelling | doaj-art-f453fbb9eaf149e2ada45a5bf30a53452025-02-03T05:58:35ZengWileyGastroenterology Research and Practice1687-61211687-630X2015-01-01201510.1155/2015/457613457613Hepatorenal Syndrome: Outcome of Response to Therapy and Predictors of SurvivalJan Heidemann0Christoph Bartels1Christoph Berssenbrügge2Hartmut Schmidt3Tobias Meister4Department of Gastroenterology, Klinikum Bielefeld, 33604 Bielefeld, GermanyDepartment of Medicine B, University of Münster, 48149 Münster, GermanyDepartment of Medicine B, University of Münster, 48149 Münster, GermanyDepartment of Transplantation Medicine, University of Münster, 48149 Münster, GermanyDepartment of Medicine II, HELIOS Albert-Schweitzer Hospital, Academic Teaching Hospital of Georg-August-University of Göttingen, 37154 Northeim, GermanyAim. 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.http://dx.doi.org/10.1155/2015/457613 |
| spellingShingle | Jan Heidemann Christoph Bartels Christoph Berssenbrügge Hartmut Schmidt Tobias Meister Hepatorenal Syndrome: Outcome of Response to Therapy and Predictors of Survival Gastroenterology Research and Practice |
| 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 |
| url | http://dx.doi.org/10.1155/2015/457613 |
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