Treatment variants in hepatorenal syndrome. Systematic review

Sebastián Emanuel Damasco and Aníbal Danilo Farias

SCT Proceedings in Interdisciplinary Insights and Innovations, 2024, vol. 2, 10.56294/piii2024331

Abstract: Introduction: hepatorenal syndrome (HRS) is a form of acute renal failure that occurs in patients with advanced cirrhosis and presents high mortality. to describe the therapeutic alternatives in hepatorenal syndrome. a search for information was carried out using the PubMed, TripDatabase and Cochrane databases; MeSH terms were used. Initially, 1749 articles were obtained; subsequently, 5 articles used in this systematic review were selected through the use of filters, review of titles, and elimination of duplicates. 548 patients were included. 325 patients received Terlipressin and 223 patients received Placebo. A reversal of SHR was evidenced in 35,8 % in patients receiving Terlipressin vs. 12,1 % placebo. Overall survival without liver transplantation was 36,7 % for the Terlipressin group and 21,1 % placebo. Adverse events were higher in the Terlipressin group. Terlipressin is effective in improving renal function in patients with cirrhosis and hepatorenal syndrome type 1 (HRS-1). However, its use is associated with serious adverse events, such as respiratory failure. The combined treatment of terlipressin and albumin shows a greater improvement in renal function compared to the use of albumin alone. Further studies are needed to determine whether the improvement in renal function translates into a survival benefit for patients. Liver transplantation remains the most definitive treatment, and should be considered early in the course of the disease

Date: 2024
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