title: Effect of various drugs used in conservative therapy of hepatorenal syndrome: a retrospective drug utilization study.
abstract: OBJECTIVE
  To analyze the impact of various drugs used in conservative therapy on renal failure and mortality in hepatorenal syndrome (HRS) at a tertiary care teaching hospital.
  
  
  METHODS
  Retrospective review of hospital admission records was conducted for case records with HRS as diagnosis. Demographic and clinical data and drug utilization pattern were collected in a pre-designed patient information sheet. Impact of various drugs especially hepatoprotector antioxidant, silymarin, on survival benefits in terms of number of patients alive, change in mean arterial pressure (MAP) and change in serum creatinine at the end of treatment period were estimated by univariate and followed by multivariate analysis.
  
  
  RESULTS
  Of the total 89 case records, 31 met the eligibility criteria and were included in the analysis. On multivariate analysis, a significant correlation between use of intravenous fluids (IVFs) and survival benefits was observed (P < 0.05); wherein patients treated with IVFs had an increase in log odds of survival by 2.42 (95% CI = 1.06 to 121.13) as compared to patient not treated with IVF. However, MAP was not affected by any of the treatment modalities. While change in serum creatinine level was not significantly (P = 0.06, regression correlation = -0.3) correlated with duration of treatment with IVFs.
  
  
  CONCLUSIONS
  Use of IVFs may be associated with better short-term survival benefits and favor HRS reversal. Use of silymarin as hepatoprotector antioxidant has no beneficial effects on HRS reversal or survival benefits.
authors.affiliation: Department of Pharmacology, Sri Dharmasthala Manjunatheshwara College of Medical Sciences and Hospital, Dharwad, Karnataka, India.
authors.forename: Sharanabasayyaswamy B
authors.initials: SB
authors.lastname: Hiremath
authors.affiliation: Department of Pharmacology, Sri Dharmasthala Manjunatheshwara College of Medical Sciences and Hospital, Dharwad, Karnataka, India.
authors.forename: Mohammed Ameeruddin
authors.initials: MA
authors.lastname: Kamdod
mesh_terms: D000328:Adult; D000368:Aged; D000975:Antioxidants / Q000627:therapeutic use*; D062186:Arterial Pressure / Q000187:drug effects; D003404:Creatinine / Q000097:blood; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006530:Hepatorenal Syndrome / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D051437:Renal Insufficiency / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D012838:Silymarin / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000975:Antioxidants; D012838:Silymarin; D003404:Creatinine
keywords: Conservative therapy; Drug utilization study; hepatorenal syndrome