title: Terlipressin in patients with cirrhosis and type 1 hepatorenal syndrome: a retrospective multicenter study.
abstract: OBJECTIVE
  Type 1 hepatorenal syndrome (HRS) is a severe complication of cirrhosis associated with a short median survival time (<2 weeks). Although the administration of terlipressin improves renal function, its effect on survival is unknown. This study investigated predictive factors of survival in patients with type 1 HRS treated with terlipressin.
  
  
  METHODS
  Ninety-nine patients with type 1 HRS treated with terlipressin in 24 centers were retrospectively studied. Terlipressin-induced improved renal function was defined as a decrease in serum creatinine value to <130 micromol/L or a decrease of at least 20% at the end of treatment.
  
  
  RESULTS
  At inclusion, the Child-Pugh score was 11.8 +/- 1.6 (mean +/- SD). Terlipressin (3.2 +/- 1.3 mg/day) was administered for 11 +/- 12 days. Renal function improved in 58% of patients (serum creatinine decreased by 46% +/- 17% from 272 +/- 114 micromol/L). Median survival time was 21 days. Survival rate was 40% at 1 month. Multivariate analysis showed that improved renal function and Child-Pugh score < or =11 at inclusion were independent predictive factors of survival (P < 0.0001 and 0.02, respectively). Thirteen patients underwent liver transplantation (92 +/- 95 days after HRS onset), 10 of whom had received terlipressin and had had improved renal function.
  
  
  CONCLUSIONS
  This retrospective uncontrolled study shows that in patients with type 1 HRS, terlipressin-induced improved renal function is associated with an increase in survival. Thus, a randomized trial investigating the effect of terlipressin on survival in patients with type 1 HRS should be performed.
authors.affiliation: INSERM U-481 et Service d'Hépatologie, Hôpital Beaujon, Clichy, France. moreau@bichat.inserm.fr
authors.forename: Richard
authors.initials: R
authors.lastname: Moreau
authors.forename: Francois
authors.initials: F
authors.lastname: Durand
authors.forename: Thierry
authors.initials: T
authors.lastname: Poynard
authors.forename: Christian
authors.initials: C
authors.lastname: Duhamel
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Cervoni
authors.forename: Philippe
authors.initials: P
authors.lastname: Ichaï
authors.forename: Armand
authors.initials: A
authors.lastname: Abergel
authors.forename: Chantal
authors.initials: C
authors.lastname: Halimi
authors.forename: Mathieu
authors.initials: M
authors.lastname: Pauwels
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Bronowicki
authors.forename: Emile
authors.initials: E
authors.lastname: Giostra
authors.forename: Cathy
authors.initials: C
authors.lastname: Fleurot
authors.forename: Danielle
authors.initials: D
authors.lastname: Gurnot
authors.forename: Olivier
authors.initials: O
authors.lastname: Nouel
authors.forename: Philippe
authors.initials: P
authors.lastname: Renard
authors.forename: Michel
authors.initials: M
authors.lastname: Rivoal
authors.forename: Pierre
authors.initials: P
authors.lastname: Blanc
authors.forename: Dimitri
authors.initials: D
authors.lastname: Coumaros
authors.forename: Sylvie
authors.initials: S
authors.lastname: Ducloux
authors.forename: Stephane
authors.initials: S
authors.lastname: Levy
authors.forename: Alexandre
authors.initials: A
authors.lastname: Pariente
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Perarnau
authors.forename: Jean
authors.initials: J
authors.lastname: Roche
authors.forename: Myriam
authors.initials: M
authors.lastname: Scribe-Outtas
authors.forename: Dominique
authors.initials: D
authors.lastname: Valla
authors.forename: Brigitte
authors.initials: B
authors.lastname: Bernard
authors.forename: Didier
authors.initials: D
authors.lastname: Samuel
authors.forename: Joël
authors.initials: J
authors.lastname: Butel
authors.forename: Antoine
authors.initials: A
authors.lastname: Hadengue
authors.forename: Andrzej
authors.initials: A
authors.lastname: Platek
authors.forename: Didier
authors.initials: D
authors.lastname: Lebrec
authors.forename: Jean-Francois
authors.initials: JF
authors.lastname: Cadranel
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006530:Hepatorenal Syndrome / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D008236:Lypressin / Q000008:administration & dosage* / Q000009:adverse effects / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D051437:Renal Insufficiency / Q000401:mortality; D012189:Retrospective Studies; D016019:Survival Analysis; D000077585:Terlipressin
chemical_list: D000959:Antihypertensive Agents; D008236:Lypressin; D000077585:Terlipressin