Terlipressin in Patients With Cirrhosis and Type 1 Hepatorenal Syndrome: A Retrospective Multicenter Study

Abstract Background & Aims: Type 1 hepatorenal syndrome (HRS) is a severe complication of cirrhosis associated with a short median survival time ( Methods: Ninety-nine patients with type 1 HRS treated with terlipressin in 24 centers were retrospectively studied. Terlipressin-induced improved renal function was defined as a decrease in serum creatinine value to Results: At inclusion, the Child–Pugh score was 11.8 ± 1.6 (mean ± SD). Terlipressin (3.2 ± 1.3 mg/day) was administered for 11 ± 12 days. Renal function improved in 58% of patients (serum creatinine decreased by 46% ± 17% from 272 ± 114 μmol/L). Median survival time was 21 days. Survival rate was 40% at 1 month. Multivariate analysis showed that improved renal function and Child–Pugh score ≤11 at inclusion were independent predictive factors of survival ( P Conclusions: This retrospective uncontrolled study shows that in patients with type 1 HRS, terlipressin-induced improved renal function is associated with an increase in survival. Thus, a randomized trial investigating the effect of terlipressin on survival in patients with type 1 HRS should be performed. GASTROENTEROLOGY 2002;122:923-930