title: Non-selective β-blockers in advanced cirrhosis: a critical review of the effects on overall survival and renal function.
abstract: BACKGROUND
  Non-selective β-blockers (NSBBs) are widely prescribed in patients with cirrhosis for primary and secondary prophylaxis of bleeding oesophageal varices. Furthermore, it has been suggested that the clinical benefits of NSBBs may extend beyond their haemodynamic effects. Recently, a potentially harmful effect has been described in patients with refractory ascites or spontaneous bacterial peritonitis.
  
  
  METHODS
  A comprehensive literature search on β-blockers and cirrhosis survival using the electronic databases PubMed/MEDLINE, AMED, CINAHL and the Cochrane Central Register of Controlled Trials. Full-text manuscripts published over more than 35 years, from 1980 to April 2016 were reviewed for relevance and reference lists were cross-checked for additional pertinent studies regarding potential NSBB effects, especially focused on those concerned with survival and/or acute kidney injury (AKI).
  
  
  CONCLUSIONS
  The proposed review will be able to provide valuable evidence to help decision making in the use of NSBB for the treatment of advanced cirrhosis and highlights some limitations in existing evidence to direct future research.
authors.affiliation: Gastroenterology Unit, Hospital Universitario Fundación Alcorcon, Madrid, Spain; University Rey Juan Carlos, Madrid, Spain.
authors.forename: Sara
authors.initials: S
authors.lastname: Blasco-Algora
authors.affiliation: Gastroenterology Unit, Hospital Universitario Fundación Alcorcon, Madrid, Spain; University Rey Juan Carlos, Madrid, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Masegosa-Ataz
authors.affiliation: Gastroenterology Unit, Hospital Universitario Fundación Alcorcon, Madrid, Spain; University Rey Juan Carlos, Madrid, Spain.
authors.forename: Sonia
authors.initials: S
authors.lastname: Alonso
authors.affiliation: Gastroenterology Unit, Hospital Universitario Fundación Alcorcon, Madrid, Spain; University Rey Juan Carlos, Madrid, Spain.
authors.forename: Maria-Luisa
authors.initials: ML
authors.lastname: Gutiérrez
authors.affiliation: Gastroenterology Unit, Hospital Universitario Fundación Alcorcon, Madrid, Spain; University Rey Juan Carlos, Madrid, Spain.
authors.forename: Conrado
authors.initials: C
authors.lastname: Fernández-Rodriguez
keywords: ASCITES; CIRRHOSIS; HEPATORENAL SYNDROME; OESOPHAGEAL VARICES