中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 36 Issue 11
Nov.  2020
Turn off MathJax
Article Contents

Treatment of hepatorenal syndrome:Vasoconstriction or vasodilation?

DOI: 10.3969/j.issn.1001-5256.2020.11.005
Research funding:

 

  • Received Date: 2020-07-29
  • Published Date: 2020-11-20
  • Hepatorenal syndrome( HRS) is a serious complication that occurs in patients with decompensated cirrhosis or acute/chronic liver failure. The main pathological features of HRS include marked peripheral vasodilation and strong renal vasoconstriction,with rapid progression,unsatisfactory treatment response,and poor prognosis. Vasoconstrictors are mainly used in the pharmacotherapy for HRS,and at present,terlipressin combined with albumin is the first-line treatment method for HRS. Some drugs with a renal vasodilatory effect also show a potential therapeutic effect. This article reviews the latest research advances in the role and clinical application of vasoactive drugs in the treatment of HRS.

     

  • loading
  • [1] GINES P,SOLAE,ANGELI P,et al. Hepatorenal syndrome[J]. Nat Rev Dis Primers,2018,4(1):23.
    [2] ANGELI P,GINES P,WONG F,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.
    [3] RESTUCCIA T,ORTEGA R,GUEVARA M,et al. Effects of treatment of hepatorenal syndrome before transplantation on posttransplantation outcome. A case-control study[J]. J Hepatol,2004,40(1):140-146.
    [4] MEOLA M,NALESSO F,PETRUCCI I,et al. Clinical scenarios in acute kidney injury:Hepatorenal syndrome[J]. Contrib Nephrol,2016,188:33-38.
    [5] LEITHEAD JA,HAYES PC,FERGUSON JW. Review article:Advances in the management of patients with cirrhosis and portal hypertension-related renal dysfunction[J]. Aliment Pharmacol Ther,2014,39(7):699-711.
    [6] WIEST R,LAWSON M,GEUKING M. Pathological bacterial translocation in liver cirrhosis[J]. J Hepatol,2014,60(1):197-209.
    [7] MANDORFER M,HECKING M. The renaissance of cholemic nephropathy:A likely underestimated cause of renal dysfunction in liver disease[J]. Hepatology,2019,69(5):1858-1860.
    [8] GLASS L,SHARMA P. Evidence-based therapeutic options for hepatorenal syndrome[J]. Gastroenterology,2016,150(4):1031-1033.
    [9] KIM HY,CHO EJ,CHUN S,et al. Red blood cell alloimmunization in korean patients with myelodysplastic syndrome and liver cirrhosis[J]. Ann Lab Med,2019,39(2):218-222.
    [10] 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.
    [11] GLUUD LL,CHRISTENSEN K,CHRISTENSEN E,et al. Terlipressin for hepatorenal syndrome[J]. Cochrane Database Syst Rev,2012,(9):CD005162.
    [12] GIFFORD FJ,MORLING JR,FALLOWFIELD JA. Systematic review with meta-analysis:Vasoactive drugs for the treatment of hepatorenal syndrome type 1[J]. Aliment Pharmacol Ther,2017,45(5):593-603.
    [13] ISRAELSEN M,KRAG A,ALLEGRETTI AS,et al. Terlipressin versus other vasoactive drugs for hepatorenal syndrome[J].Cochrane Database Syst Rev,2017,9(9):CD011532.
    [14] NGUYEN-TAT M,JAGER J,REY JW,et al. Terlipressin and albumin combination treatment in patients with hepatorenal syndrome type 2[J]. United European Gastroenterol J,2019,7(4):529-537.
    [15] 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.
    [16] QIN YX,LONG FL,MAO DW,et al. Efficacy and safety of norepinephrine combined with albumin versus terlipressin combined with albumin in treatment of type 1 hepatorenal syndrome:A Meta-analysis[J]. J Clin Hepatol,2019,35(10):2266-2271.(in Chinese)覃艳新,龙富立,毛德文,等.去甲肾上腺素或特利加压素联合白蛋白治疗1型肝肾综合征效果及安全性比较的Meta分析[J].临床肝胆病杂志,2019,35(10):2266-2271.
    [17] ZIRONI G,ROSSI C,SIRINGO S,et al. Short-and longterm hemodynamic response to octreotide in portal hypertensive patients:A double-blind,controlled study[J]. Liver,1996,16(4):225-234.
    [18] CAVALLIN M,KAMATH PS,MERLI M,et al. Terlipressin plus albumin versus midodrine and octreotide plus albumin in the treatment of hepatorenal syndrome:A randomized trial[J].Hepatology,2015,62(2):567-574.
    [19] WANG L,LONG Y,LI KX,et al. Pharmacological treatment of hepatorenal syndrome:A network meta-analysis[J]. Gastroenterol Rep(Oxf),2020,8(2):111-118.
    [20] European Association for the Study of the Liver. EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis[J]J Hepatol,2018,69(2):406-460.
    [21] SRIVASTAVA S,SHALIMAR,VISHNUBHATLA S,et al. Randomized controlled trial comparing the efficacy of terlipressin and albumin with a combination of concurrent dopamine,furosemide,and albumin in hepatorenal syndrome[J]. J Clin Exp Hepatol,2015,5(4):276-285.
    [22] SCHRIER RW,GROSS P,GHEORGHIADE M,et al. Tolvaptan,a selective oral vasopressin V2-receptor antagonist,for hyponatremia[J]. N Engl J Med,2006,355(20):2099-2112.
    [23] PIAO LS. Clinical effect of tolvaptan combined with albumin in treatment of liver cirrhosis patients with type 2 hepatorenal syndrome[J]. Guide China Med,2015,13(25):150.(in Chinese)朴莲淑.托伐普坦联合白蛋白治疗肝硬化合并2型肝肾综合征的疗效观察[J].中国医药指南,2015,13(25):150.
    [24] HIRAMINE Y,UTO H,MAWATARI S,et al. Effect of tolvaptan on the prognosis of patients with hepatic ascites[J]. Hepatol Res,2019,49(7):765-777.
    [25] SNOWDON VK,LACHLAN NJ,HOY AM,et al. Serelaxin as a potential treatment for renal dysfunction in cirrhosis:Preclinical evaluation and results of a randomized phase 2 trial[J]. PLo S Med,2017,14(2):e1002248.
    [26] DE BK,GANGOPADHYAY S,DUTTA D,et al. Pentoxifylline versus prednisolone for severe alcoholic hepatitis:A randomized controlled trial[J]. World J Gastroenterol,2009,15(13):1613-1619.
  • 加载中

Catalog

    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

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Article Metrics

    Article views (541) PDF downloads(94) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return