An experience of terlipressin therapy for patients with hepatorenal syndrome

Abstract

Effect of terlipressin on hepatorenal syndrome was investigated in 8 patients with liver cirrhosis. Terlipressin (1-3 mg/day) and albumin (12.5-37.5 g/day) were administered for a mean period of 4 days (1-14 days). Urine volume, urine sodium excretion, and creatinine clearance increased significantly [from 834 ± 541 to 1182 ± 664 ml (p = 0.04), from 24.7 ± 17.4 mEq/day to 51.7 ± 38.7 mEq/day (p = 0.01), and from 14.5 ± 7.6 ml/min to 28 ± 16.2 ml/min (p = 0.03), respectively], while serum creatinine level and plasma renin activity fell significantly [from 2.43 ± 0.75 mg/dl to 1.81 ±± 0.72 mg/dl (p = 0.03) and 8.6 ± 7.9 ng/ml/hr to 5.1 ± 6.6 ng/ml/hr (p = 0.03), respectively] after the treatment. Diarrhea and abdominal cramp events were seen in 5 and 3 patients, respectively, during the treatment, and they required reduction of the dose of terlipressin in 1 patient and discontinuation of the treatment in 1 patient. These results suggest that terlipressin, together with albumin, safely and effectively improves hepatorenal syndrome by increasing effective arterial blood volume and glomerular filtration rate.