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Terlipressin May Decrease In-Hospital Mortality of Cirrhotic Patients with Acute Gastrointestinal Bleeding and Renal
Xiangbo Xu1, Bang Liu2, Su Lin3
1Department of Gastroenterology, General Hospital of Northern Theater Command (Formerly Called General Hospital of Shenyang Military Area), Shenyang, China.
Advances in Therapy
|August 30, 2020
Summary
Terlipressin may reduce in-hospital mortality for cirrhotic patients experiencing acute gastrointestinal bleeding and renal dysfunction. This treatment shows promise for improving outcomes in this high-risk patient group.
Area of Science:
- Gastroenterology
- Nephrology
- Pharmacology
Background:
- Acute gastrointestinal bleeding (GIB) can lead to acute kidney injury (AKI) by reducing blood volume.
- Terlipressin, a splanchnic vasoconstrictor, increases renal perfusion and is used for GIB and hepatorenal syndrome.
- Cirrhotic patients with GIB and renal impairment are a vulnerable population.
Purpose of the Study:
- To investigate the incidence of renal impairment and in-hospital mortality in cirrhotic patients with acute GIB.
- To evaluate the effect of terlipressin on mortality in these patients, particularly those with renal dysfunction.
Main Methods:
- Retrospective analysis of 1644 cirrhotic patients with acute GIB from a Chinese multi-center study.
- AKI defined by International Club of Ascites (ICA) criteria; renal dysfunction by serum creatinine levels.
- Primary endpoints: incidence of renal impairment and in-hospital mortality.
Main Results:
- Incidence of ICA-AKI stages 1B, 2, and 3 was 1.8%, and renal dysfunction was 5.0%.
- Renal dysfunction and ICA-AKI stages 1B-3 significantly increased in-hospital mortality.
- Terlipressin significantly decreased mortality in patients with renal dysfunction (3.6% vs. 20.0%).
Conclusions:
- Renal dysfunction is a significant predictor of mortality in cirrhotic patients with acute GIB.
- Terlipressin may be a beneficial therapeutic option for reducing in-hospital mortality in cirrhotic patients with acute GIB and renal dysfunction.
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