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  1. Article: Systematic review: renal and other clinically relevant outcomes in hepatorenal syndrome trials.

    Tandon, P / Bain, V G / Tsuyuki, R T / Klarenbach, S

    Alimentary pharmacology & therapeutics

    2007  Volume 25, Issue 9, Page(s) 1017–1028

    Abstract: ... Aim: To review trials of pharmacologic interventions in hepatorenal syndrome, with specific ... lack of power, and limited use of clinically relevant outcomes. There is insufficient information ... The validity of renal outcome measures as surrogate markers of more clinically relevant endpoints has not been ...

    Abstract Background: Although reversal of pretransplant renal dysfunction in hepatorenal syndrome reduces post-transplant complications, the overall impact on morbidity and mortality requires clarification.
    Aim: To review trials of pharmacologic interventions in hepatorenal syndrome, with specific assessment of trial quality and study endpoints, including patient survival and renal outcome measures.
    Methods: Literature search and selection was carried out by a single reviewer. Data extraction and quality analysis were carried out by two independent reviewers.
    Results: Of 848 identified articles, 36 were eligible for inclusion. Twenty-one were full-text. Only 19% were randomized-controlled trials. About 50% of studies included only Type 1 hepatorenal syndrome patients. Serum creatinine, urine output and urine sodium were the most common renal outcome measures. Only 42% defined a primary renal endpoint. About 88% of articles reported mortality rates.
    Conclusions: Existing literature of pharmacologic agents for use in hepatorenal syndrome is limited by poor study design, including non-randomization, heterogeneous study populations, lack of power, and limited use of clinically relevant outcomes. There is insufficient information in most trials to judge the impact of pharmacologic therapy on mortality or rates of transplantation. The validity of renal outcome measures as surrogate markers of more clinically relevant endpoints has not been established.
    MeSH term(s) Female ; Hepatorenal Syndrome/complications ; Hepatorenal Syndrome/drug therapy ; Hepatorenal Syndrome/mortality ; Humans ; Male ; Multicenter Studies as Topic ; Prospective Studies ; Randomized Controlled Trials as Topic ; Retrospective Studies ; Survival Analysis
    Language English
    Publishing date 2007-05-01
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 639012-2
    ISSN 1365-2036 ; 0269-2813 ; 0953-0673
    ISSN (online) 1365-2036
    ISSN 0269-2813 ; 0953-0673
    DOI 10.1111/j.1365-2036.2007.03303.x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2206: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Role of Terlipressin in Cirrhotic Patients with Ascites and without Hepatorenal Syndrome: A Systematic Review of Current Evidence.

    Bai, Zhaohui / An, Yang / Guo, Xiaozhong / Teschke, Rolf / Méndez-Sánchez, Nahum / Li, Hongyu / Qi, Xingshun

    Canadian journal of gastroenterology & hepatology

    2020  Volume 2020, Page(s) 5106958

    Abstract: ... without hepatorenal syndrome. PubMed, EMBASE, and Cochrane Library databases were searched for relevant studies. Twelve studies ... hepatorenal syndrome and can be complicated by circulatory dysfunction after paracentesis. Terlipressin has not been ... dysfunction in cirrhosis with ascites and without hepatorenal syndrome. However, no study has evaluated ...

    Abstract Ascites, a common complication in cirrhosis, is prone to the development of acute kidney injury or hepatorenal syndrome and can be complicated by circulatory dysfunction after paracentesis. Terlipressin has not been considered as the mainstay treatment option for ascites in cirrhosis yet. The present work aimed to systematically review the current evidence regarding the use of terlipressin in cirrhosis with ascites and without hepatorenal syndrome. PubMed, EMBASE, and Cochrane Library databases were searched for relevant studies. Twelve studies were eligible. In 3 studies (1 randomized controlled trial and 2 single-arm studies without controls) involving 32 patients who received terlipressin for nonrefractory ascites, terlipressin improved hemodynamics by decreasing the heart rate and cardiac output and increasing the mean arterial pressure and systemic vascular resistance. In 5 studies (1 randomized controlled trial, 2 single-arm studies without controls, and 2 comparative studies with controls) involving 67 patients who received terlipressin for refractory ascites, terlipressin improved renal function by increasing the glomerular filtration rate, renal blood flow, urinary sodium, and urine output and decreasing serum creatinine. In 4 studies (4 randomized controlled trials) involving 71 patients who received terlipressin for preventing from paracentesis-induced circulatory dysfunction, terlipressin prevented from paracentesis-induced circulatory dysfunction by increasing the mean arterial pressure and systemic vascular resistance and decreasing plasma renin. Terlipressin may improve hemodynamics, severity of ascites, and renal function and prevent from paracentesis-induced circulatory dysfunction in cirrhosis with ascites and without hepatorenal syndrome. However, no study has evaluated the effect of terlipressin for prevention of acute kidney injury.
    MeSH term(s) Arterial Pressure/drug effects ; Ascites/drug therapy ; Ascites/physiopathology ; Clinical Trials as Topic ; Glomerular Filtration Rate/drug effects ; Hemodynamics/drug effects ; Humans ; Kidney/drug effects ; Liver Cirrhosis/drug therapy ; Liver Cirrhosis/physiopathology ; Paracentesis/adverse effects ; Postoperative Complications/etiology ; Postoperative Complications/prevention & control ; Renal Circulation/drug effects ; Terlipressin/therapeutic use ; Treatment Outcome ; Vascular Diseases/etiology ; Vascular Diseases/prevention & control ; Vascular Resistance/drug effects ; Vasoconstrictor Agents/therapeutic use
    Chemical Substances Vasoconstrictor Agents ; Terlipressin (7Z5X49W53P)
    Language English
    Publishing date 2020-06-22
    Publishing country Egypt
    Document type Journal Article ; Systematic Review
    ZDB-ID 2762182-0
    ISSN 2291-2797 ; 1916-7237 ; 0835-7900
    ISSN (online) 2291-2797 ; 1916-7237
    ISSN 0835-7900
    DOI 10.1155/2020/5106958
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2360: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

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