Midodrine, octreotide, albumin, and TIPS in selected patients with cirrhosis and type 1 hepatorenal syndrome

Wong, Florence; Pantea, Lavinia; Sniderman, Kenneth W.

doi:10.1002/hep.20262

Cited by 361 publications

(216 citation statements)

References 41 publications

(55 reference statements)

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“…84 For refractory ascites and progressive HRS, small clinical studies in selected patients have found that transjugular intrahepatic portosystemic shunting may attenuate and/or improve kidney function over several weeks to months. [85][86][87] In a small clinical trial, extracorporeal liver support with the molecular adsorbents recirculation system was shown to improve both kidney function and to extend survival in advanced cirrhosis with established HRS; however, confirmatory data are pending. 88 In progressive HRS, extracorporeal RRT in eligible patients can be used to support loss of kidney function and as a bridge until liver transplantation.…”

Section: Secondary Cardio-renal Syndromes (Type 5 Crs)mentioning

confidence: 99%

Review article: Acute kidney injury in critical illness

Bagshaw

Bellomo

Devarajan

et al. 2010

Can J Anesth/J Can Anesth

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Purpose This review provides a focused and comprehensive update on emerging evidence related to acute kidney injury (AKI).Principal findings Acute kidney injury is a significant clinical problem that increasingly complicates the course of hospitalization and portends worse clinical outcome for sick hospitalized patients. The recent introduction of consensus criteria for the diagnosis of AKI (i.e., RIFLE/AKIN classification) have greatly improved our capacity not only to standardize the diagnosis and classification of severity of AKI, but also to facilitate conducting comparative epidemiologic studies in an effort to better understand the burden of adult and pediatric AKI and its syndromes (i.e., septic, cardio-renal, hepato-renal). The characterization of several novel AKI-specific biomarkers (i.e., neutrophil gelatinase-associated lipocalin, kidney injury molecule-1, and interleukin-18) is extending our understanding of the pathophysiology of AKI. Moreover, these biomarkers appear to have clinical relevance for early detection and they provide prognostic value. These innovations are aiding in the design of epidemiologic surveys and randomized trials of therapeutic interventions. Strategies for prevention Editor's Note: This article is the first of two linked special review articles published in this issue of the Journal. The concept of these articles emerged from the scientific content of the 2010 Acute Kidney Injury (AKI) and Renal Support in Critical Illness Symposium, hosted in Edmonton, Alberta. This review (Part 1) provides a focused and comprehensive update on emerging evidence in the diagnosis and classification of AKI, on specific AKI syndromes, and on the prevention and conservative management of hospitalized patients with AKI. Abstracts presented at this meeting were selected on the basis of peer review by the Scientific Committee and were accepted for presentation at the AKI 2010 Symposium, and appear as Electronic Supplementary Material at

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Section: Secondary Cardio-renal Syndromes (Type 5 Crs)mentioning

confidence: 99%

Review article: Acute kidney injury in critical illness

Bagshaw

Bellomo

Devarajan

et al. 2010

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

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“…Similarly, Krag and colleagues found that patients with a low cardiac index (< 1.5L/ min/m 2 ) significantly developed more hepatorenal syndrome and had decreased survival rate compared to those with a cardiac index above 1.5 L/min/m 2 [33] . Correspondingly, several studies confirmed this concept by showing that midodrine, an alpha-1 adrenergic agonist, was beneficial in patients with advanced cirrhosis [35][36][37][38][39] . Midodrine therapy increased urinary volume, urinary sodium excretion, blood pressure, and decreased plasma renin activity and overall mortality [39] .…”

Section: Blood Pressure and Cirrhosismentioning

confidence: 98%

Non-Selective Beta-Blockers in Liver Cirrhosis: Friends or Foes? A Review of the Literature

Abboud

Tabet

2016

Journal of Gastroenterology and Hepatology Research

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in cirrhosis, and try to provide logical suggestions concerning the use of this class of medication in patients with cirrhosis. INTRODUCTIONCirrhosis is becoming a leading cause of mortality and morbidity worldwide [1,2] , and since 1981, beta-blockers were found to be highly efficacious in both, primary and secondary prevention of variceal bleeding [3] . Non-selective beta-blockers (NSBB) became the cornerstone of the medical treatment of patients with cirrhosis [3] , and this was demonstrated in several solid studies. However, recent evidence has questioned the use of beta-blockers in patients with end-stage liver disease and refractory ascites [3] . In this article, we are going to review almost all the previous studies about beta-blocker therapy in patients with cirrhosis, and find out the beneficial effects of this therapy, its potential complications and harms, and try to provide suggestions regarding its appropriate use in this specific category of patients. CIRRHOSISCirrhosis represents an advanced stage of progressive hepatic fibrosis characterized by distortion of the hepatic architecture and the formation of regenerative nodules. It is normally considered to be irreversible in its late stages at which point the only therapeutic ABSTRACTCirrhosis has become a leading cause of death in the United States and worldwide owing the increased prevalence of alcoholic liver disease, hepatitis C, and more recently, non-alcoholic steatohepatitis and nonalcoholic fatty liver disease. Beta-blockers have been proven to be efficacious in primary, as long as secondary prophylaxis of variceal bleeding, more than 35 years ago. Nonetheless, recent data has cautioned the use of beta-blockers in patients with end-stage cirrhosis and refractory ascites suggesting increased mortality from betablockers in this group of patients. In this article, we will discuss this topic in details, and review the conflicting studies about beta-blockers REVIEW

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“…30 Notably, not all the components of the MELD score likely contribute equally to the risk, and patients with lower bilirubin (<5 mg/dL) but HRS may be at a lower risk for death after TIPS because of the possible treatment of HRS by TIPS. 31 Therefore, in the setting of life-threatening variceal hemorrhage, this should be taken into consideration.…”

Section: Variceal Bleedingmentioning

confidence: 99%