Efficacy and safety of norepinephrine combined with albumin versus terlipressin combined with albumin in treatment of type 1 hepatorenal syndrome:A Meta-analysis

Tan YanXin; Long FuLi; Mao DeWen; Zhang JianLing; Ma YuZhen; Yan LianJie

doi:10.3969/j.issn.1001-5256.2019.10.027

Volume 35 Issue 10

Oct. 2019

Turn off MathJax

Article Contents

Abstract

References

Article Navigation > Journal of Clinical Hepatology > 2019 > 35(10): 2266-2271

PDF( 2481 KB)

Efficacy and safety of norepinephrine combined with albumin versus terlipressin combined with albumin in treatment of type 1 hepatorenal syndrome:A Meta-analysis

DOI: 10.3969/j.issn.1001-5256.2019.10.027

Guangxi University of Chinese Medicine

Research funding:

Received Date: 2019-06-06
Published Date: 2019-10-20

Abstract

Abstract

Objective To systematically review the efficacy and safety of norepinephrine combined with albumin versus terlipressin combined with albumin in the treatment of type 1 hepatorenal syndrome(HRS1). Methods Pub Med,EMBASE,Medline,Cochrane Library,CNKI,Wanfang Data,and VIP were searched for comparative studies on norepinephrine combined with albumin versus terlipressin combined with albumin in the treatment of HRS1. Quality assessment was performed for articles. Related indicators were extracted,including hepatorenal syndrome(HRS) reversal rate,mortality rate,incidence of adverse events,mean arterial pressure,and renal function,and Review Manager 5. 3 was used for data analysis. The chi-square test was used to determine the heterogeneity between studies. Odds ratio(OR) was used for the analysis of dichotomous variables,weighted mean difference(WMD) was used for the analysis of continuous variables,and 95% confidence interval(CI) was calculated for these two types of variables. Results A total of 6 randomized controlled trials which met the inclusion criteria were included,with a total sample size of 298 patients(149 patients in the norepinephrine + albumin group and 149 in the terlipressin + albumin group). The meta-analysis showed that there were no significant differences between the two groups in HRS reversal rate(OR = 0. 95,95% CI: 0. 6-1. 49,P = 0. 81),mortality rate(OR = 0. 84,95% CI: 0. 51-1. 41,P = 0. 51),incidence rate of adverse events(OR =0. 42,95% CI: 0. 16-1. 07,P = 0. 07),mean arterial pressure(standardized mean difference = 0. 05,95% CI:-0. 92 to 1. 03,P = 0. 92),and renal function. Conclusion Norepinephrine combined with albumin has similar efficacy and safety as terlipressin combined with albumin in the treatment of HRS1,and terlipressin can be replaced by norepinephrine in clinical practice when necessary.
- hepatorenal syndrome,
- norepinephrine,
- terlipressin,
- serum albumin,
- Meta-analysis as topic

FullText(HTML)

References(30)

References

[1] FUKUI H,SAITO H,UENO Y,et al. Evidence-based clinical practice guidelines for liver cirrhosis 2015[J]. J Gastroenterol,2016,51(7):629-650.

[2] SALERNO F,CAZZANIGA M,MERLI M,et al. Diagnosis,treatment and survival of patients with hepatorenal syndrome:A survey on daily medical practice[J]. J Hepatol,2011,55(6):1241-1248.

[3] HEIDEMANN J,BARTELS C,BERSSENBRGGE C,et al.Hepatorenal syndrome:Outcome of response to therapy and predictors of survival[J]. Gastroenterol Res Pract,2015,45(7):6-13.

[4] KURT L,ROBERT B,LISBETH K,et al. Treatment and management of ascites and hepatorenal syndrome:An update[J]. Therap Adv Gastroenterol,2015,8(2):83-100.

[5] GIN SA,ESCORSELL A,GIN SP,et al. Incidence,predictive factors,and prognosis of the hepatorenal syndrome in cirrhosis with ascites[J]. Gastroenterology,1993,105(1):229-236.

[6] GIN SP,GUEVARA M,ARROYO V,et al. Hepatorenal syndrome[J]. Lancet,2003,36(2):1819-1827.

[7] BOYER TD,SANYAL AJ,GARCIA-TSAO G,et al. Impact of liver transplantation on the survival of patients treated for hepatorenal syndrome type 1[J]. Liver Transpl,2011,17(11):1328-1332.

[8] UTAKO P,EMYOO T,ANOTHAISINTAWEE T,et al. Clinical outcomes after liver transplantation for hepatorenal syndrome:A systematic review and meta-analysis[J]. Biomed Res Int,2018,2018(5):s1123.

[9] GLUUD LL,KURT C,ERIK C,et al. Systematic review of randomized trials on vasoconstrictor drugs for hepatorenal syndrome[J]. Hepatology,2010,51(2):576-584.

[10] SUN MY,TANG SH,ZENG WZ,et al. An excerpt of 2017KASL clinical practice guidelines for liver cirrhosis:Ascites and related complications[J]. J Clin Hepatol,2018,34(9):1877-1878.(in Chinese)孙梦滢,汤善宏,曾维政.《2017年韩国肝病学会临床实践指南:肝硬化-腹水及相关并发症》摘译[J].临床肝胆病杂志,2018,34(9):1877-1878.

[11] SANYAL AJ,BOYER T,GARCIA-TSAO G,et al. A randomized,prospective,double-blind,placebo-controlled trial of terlipressin for type 1 hepatorenal syndrome[J]. Gastroenterology,2008,134(5):1360-1368.

[12] FRANCESCO S,ALEXANDER G,PERE G,et al. Diagnosis,prevention and treatment of hepatorenal syndrome in cirrhosis[J]. Gut,2007,84(998):1310-1318.

[13] PAOLO A,PERE G,FLORENCE W,et al. Diagnosis and management of acute kidney injury in patients with cirrhosis:Revised consensus recommendations of the International Club of Ascites[J]. J Hepatol,2015,62(4):968-974.

[14] ARROYO V,GINES P,GERBES AL,et al. Definition and diagnostic criteria of refractory ascites and hepatorenal syndrome in cirrhosis[J]. Hepatology,1996,23(1):164-176.

[15] SHARMA P,KUMAR A,SHRAMA BC,et al. An open label,pilot,randomized controlled trial of noradrenaline versus terlipressin in the treatment of type 1 hepatorenal syndrome and predictors of response[J]. Am J Gastroenterol,2008,103(103):1689-1697.

[16] SINGH V,GHOSH S,SINGH B,et al. Noradrenaline vs. terlipressin in the treatment of hepatorenal syndrome:A randomized study[J]. J Hepatol,2012,56(6):1293-1298.

[17] GOYAL O,SIDHU SS,SEHGAL N,et al. Noradrenaline is as effective as terlipressin in hepatorenal syndrome type 1:A prospective,randomized trial[J]. J Assoc Physicians India,2016,64(9):30-35.

[18] SAIF RU,DAR HA,SOFI SM,et al. Noradrenaline versus terlipressin in the management of type 1 hepatorenal syndrome:A randomized controlled study[J]. Indian J Gastroenterol,2018,37(5):424-429.

[19] INDRABI RA,JAVID G,ZARGAR SA,et al. Noradrenaline is equally effective as terlipressin in reversal of type 1 hepatorenal syndrome:A randomized prospective study[J]. J Clin Exp Hepatol,2013,3(1):s97.

[20] BADAWY S,MECKAWY N,AHMED A. Norepinephrine versus terlipressin in patients with type 1 hepatorenal syndrome refractory to treatment with octreotide,midodrine,and albumin(a prospective randomized comparative study)[J]. Egyptian J Cardiothorac Anesth,2013,7(1):13-18.

[21] VICENTE A,JAVIER F. Management of hepatorenal syndrome in patients with cirrhosis[J]. Nat Rev Nephrol,2011,7(9):517-526.

[22] BRIGLIA AE,ANANIA FA. Hepatorenal syndrome. Definition,pathophysiology,and intervention[J]. Crit Care Clin,2002,18(2):345-373.

[23] LAURENCE L,SIBA K,ISABELLE CD,et al. Impact of molecular adsorbent recirculating system on renal recovery in type-1 hepatorenal syndrome patients with chronic liver failure[J].J Gastroenterol Hepatol,2013,28(6):1019-1024.

[24] CORT JH,ALBRECHT I,NOVAKOVA J,et al. Rregional and systemic haemodynamic effect of somevasopressins:Structural features of the hormone which prolong activity[J]. Eur J Clin Invest,1975,5(2):165-175.

[25] PAPALUCA T,GOW P. Terlipressin:Current and emerging indications in chronic liver disease[J]. Gastroenterol Hepatol,2018,33(3):591-598.

[26] KURT L. Noradrenaline in the treatment of patients with hepatorenal syndrome-back to the roots?[J]. J Hepatol,2012,57(4):925-926.

[27] SRIDHARAN K,SIVARAMAKRISHNAN G. Vasoactive agents for hepatorenal syndrome:A mixed treatment comparison network meta-analysis and trial sequential analysis of randomized clinical trials[J]. J Gen Intern Med,2017,33(1):97-102.

[28] NANDA A,REDDY R,SAFRAZ H,et al. Pharmacological therapies for hepatorenal syndrome:A systematic review and meta-analysis[J]. J Clin Gastroenterol,2018,52(4):360-367.

[29] NASSAR JUNIOR AP,FARIAS AQ,D'ALBUQUERQUE LA,et al. Terlipressin versus norepinephrine in the treatment of hepatorenal syndrome:A systematic review and meta-analysis[J]. PLo S ONE,2014,9(9):e107466.

[30] LIU QY,LI H. Changes in diagnostic criteria for hepatorenal syndrome and the application of new renal injury indices in cirrhotic patients[J]. J Clin Hepatol,2018,34(6):1308-1312.(in Chinese)刘沁雨,李海.肝肾综合征临床诊断标准的变迁及新的肾损伤指标在肝硬化患者中的应用[J].临床肝胆病杂志,2018,34(6):1308-1312.

Relative Articles

[1]	Hepatobiliary Study Group of Chinese Society of Gastroenterology of Chinese Medical Association, Hepatology Committee of Chinese Research Hospital Association. Practice guidance for the use of terlipressin for liver cirrhosis related complications (2021)[J]. Journal of Clinical Hepatology, 2022, 38(8): 1733-1738. doi: 10.3969/j.issn.1001-5256.2022.08.006
[2]	Weiming YU, Wenqian HONG, Binglun SUN, Jingzhao HAN, Hongfang TUO. Value of albumin-bilirubin grade in predicting liver function changes and prognosis of hepatocellular carcinoma patients undergoing transarterial chemoembolization: A Meta-analysis[J]. Journal of Clinical Hepatology, 2021, 37(11): 2575-2583. doi: 10.3969/j.issn.1001-5256.2021.11.018
[3]	Tingpeng HU, Sudan TANG, Zebo YU. Relationship between vitamin D level in children and adolescents with nonalcoholic fatty liver disease: A Meta-analysis[J]. Journal of Clinical Hepatology, 2021, 37(3): 627-631. doi: 10.3969/j.issn.1001-5256.2021.03.024
[4]	Qianmei CAO, Zhechuan MEI. Predictive factors for the therapeutic effect of terlipressin combined with albumin in hepatorenal syndrome[J]. Journal of Clinical Hepatology, 2021, 37(10): 2439-2443. doi: 10.3969/j.issn.1001-5256.2021.10.038
[5]	Li XiaoJing, Sun YuanLong, Zhang BinBin, Mei ZuBing, Feng Qin, Hu YiYang. Efficacy and safety of sodium-glucose co-transporter 2 inhibitors in treatment of type 2 diabetes mellitus with nonalcoholic fatty liver disease: A meta-analysis[J]. Journal of Clinical Hepatology, 2020, 36(10): 2241-2247. doi: 10.3969/j.issn.1001-5256.2020.10.016
[6]	Liu ShenShen, Xing YiQing, Wang Ning, Yu QiaoLing, Ceng LePing. Clinical effect of vitamin E in treatment of nonalcoholic fatty liver disease in children: A Meta-analysis[J]. Journal of Clinical Hepatology, 2020, 36(7): 1545-1550. doi: 10.3969/j.issn.1001-5256.2020.07.019
[7]	Li XiaoLu, Ding HuiGuo, Ceng AJuan, Lu: XinYue, Li Lei. Clinical effect of terlipressin combined with somatostatin in treatment of esophagogastric variceal bleeding with liver cirrhosis[J]. Journal of Clinical Hepatology, 2020, 36(6): 1273-1277. doi: 10.3969/j.issn.1001-5256.2020.06.017
[8]	Li XiaoLu, Li Lei. Application of terlipressin in the treatment of esophagogastric variceal bleeding in liver cirrhosis[J]. Journal of Clinical Hepatology, 2019, 35(10): 2308-2311. doi: 10.3969/j.issn.1001-5256.2019.10.038
[9]	Feng QingLing, Feng ZeMin, Zhang ChunQing, Wang GuangChuan, Feng Hua. Effects of terlipressin and double- dose octreotide on hepatic venous pressure gradient in patients with liver cirrhosis:a comparative study[J]. Journal of Clinical Hepatology, 2016, 32(4): 720-723. doi: 10.3969/j.issn.1001-5256.2016.04.022
[10]	Xia YuLian, Zhang ChunQing, Wang GuangChuan, Feng Hua, Zhang MingYan. Individual and combined effects of octreotide and terlipressin on hepatic venous pressure gradient in cirrhotic patients[J]. Journal of Clinical Hepatology, 2015, 31(2): 214-218. doi: 10.3969/j.issn.1001-5256.2015.02.017
[11]	Zhan GuoQing, Li Fang, Li RuGui, Guo Peng, Liu Xiang, Zhang WeiWei, Tan HuaBing. Efficacy of terlipressin therapy for refractory ascites in cirrhosis and type-2 hepatorenal syndrome[J]. Journal of Clinical Hepatology, 2015, 31(8): 1287-1290. doi: 10.3969/j.issn.1001-5256.2015.08.025
[12]	Ding XiaoHong, Gu JianYing. Clinical efficacy of terlipressin in treatment of type II hepatorenal syndrome[J]. Journal of Clinical Hepatology, 2015, 31(5): 745-748. doi: 10.3969/j.issn.1001-5256.2015.05.027
[13]	Gao BaoXiu, Nie Xin, He Yong, Yang ZhengBing, Luo TongXing, Song HaoLan, Li GuiXing. Analysis of endotoxin and endothelin-1 levels in patients with type 1 hepatorenal syndrome[J]. Journal of Clinical Hepatology, 2014, 30(1): 58-61. doi: 10.3969/j.issn.1001-5256.2014.01.016
[14]	Chen Si, Sun ZhangYu, Zhang ZhiHao, Wang YingYing. Therapeutic effect of terlipressin combined with albumin in 24 patients with hepatorenal syndrome[J]. Journal of Clinical Hepatology, 2014, 30(8): 782-784. doi: 10.3969/j.issn.1001-5256.2014.08.021
[15]	Zheng XiaoLi, Wang LiangZhi, He JianHua, Xiang XingChao, Zhou XiangYu. Diagnostic value of serum cystatin C and urotensin II for hepatorenal syndrome in patients with decompensated liver cirrhosis[J]. Journal of Clinical Hepatology, 2013, 29(8): 627-630. doi: 10.3969/j.issn.1001-5256.2013.08.019
[16]	Gao BaoXiu, Nie Xin, Wu Bin, He Yong, Song HaoLan, Luo TongXing, Xu Jing, Li GuiXing. Implications of elevated levels of prostaglandin I2 and thromboxane A2 in type I hepatorenal syndrome[J]. Journal of Clinical Hepatology, 2012, 28(11): 860-862.
[17]	Xu XiaoYuan, Zheng YingYing. Hepatorenal syndrome-vasoconstrictor or vasodilator?[J]. Journal of Clinical Hepatology, 2011, 27(8): 801-803+817.
[19]	Chen WeiHua, Li WenYong, Deng DaiFu. Observation of terlipressin with retention-enema of traditional Chinese drug in management of patients with hepatorenal syndrome[J]. Journal of Clinical Hepatology, 2008, 24(5): 351-353.

Supplements(0)

Cited By

Cited by

Periodical cited type(8)

1.	中华医学会肝病学分会. 肝硬化腹水诊疗指南(2023年版). 中华肝脏病杂志. 2023(08): 813-826 .
2.	念其春. 人血白蛋白联用特利加压素对Ⅱ型肝肾综合征患者肝功能的影响研究. 海峡药学. 2022(06): 142-143 .
3.	袁周，陈齐红. 特利加压素联合去甲肾上腺素治疗脓毒症患者的效果及对免疫功能的影响. 中国医学创新. 2022(25): 64-67 .
4.	刘建军，郑文凯，王江红，任燕军，刘研，赵利珍. 终末期肝病血管活性物抵抗发生机制与诊疗关系的争议和对策. 临床肝胆病杂志. 2022(10): 2408-2411 . 本站查看
5.	杨黎宏，杨晋辉. 肝肾综合征门体循环失衡的机制与治疗. 临床肝胆病杂志. 2021(12): 2770-2773 . 本站查看
6.	陈小琴，林志刚，陈彬. 特利加压素联合人血白蛋白治疗失代偿期乙型肝炎肝硬化并发肝肾综合征的临床效果评价. 中国现代药物应用. 2021(24): 7-10 .
7.	毛迎春，罗俊华. 前列地尔联合特利加压素对高龄肝肾综合征患者血栓素B2和6-酮-前列腺素F1α表达的影响. 检验医学与临床. 2020(13): 1863-1866 .
8.	李晓芸，华静. 肝肾综合征的治疗:缩血管还是扩血管治疗?. 临床肝胆病杂志. 2020(11): 2419-2422 . 本站查看

Other cited types(2)

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Get Citation

PDF

XML

Article Metrics

Article views (1571) PDF downloads(244)

Efficacy and safety of norepinephrine combined with albumin versus terlipressin combined with albumin in treatment of type 1 hepatorenal syndrome:A Meta-analysis

DOI: 10.3969/j.issn.1001-5256.2019.10.027

Abstract

References

Relative Articles

Cited by

Periodical cited type(8)

Other cited types(2)

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

About Journal

Submission Guideline

Journal Online

Hepatobiliary College

Guidelines

Export File

Citation

Format

Content