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- W1452391417 abstract "Renal failure is the most powerful predictor of death in decompensated cirrhosis. We conducted this prospective, observational, cohort study to determine the factors influencing hepatorenal syndrome (HRS) development, survival and determine predictors of response and outcome in terlipressin responders. Cirrhotic patients were diagnosed with AKI as per (IAC/ADQI - International Ascites Club/Acute Dialysis Quality Initiative) definition and evaluated as per the study protocol after taking written informed consent and applying inclusion exclusion criteria. The patients who received terlipressin were analysed for predictors of terlipressin response. Those patients with diagnosis of HRS were analysed for the factors influencing its development and survival. 395 consecutive cirrhotic patients with renal impairment defined as per protocol definitions were included. Out of these AKI patients HRS was seen in 85 patients (21.5%). Terlipressin was given to 162 patients, 72 (44%) patients responded to terlipressin as per the study definition. 90 (56%) patients were terlipressin non responders. HRS had the worst survival outcome, around 20% at 30 days and less than 10% at 90 days. Significantly worst survival was seen in terlipressin non responders at around 10% and less than 10% at 30 days and 90 days respectively as compared to terlipressin responders with 30 day survival around 50% and 90 day survival at around 20% respectively. Higher MELD score, low Serum albumin, presence of SBP and presence of hypotension with inotrope requirement were more significantly associated with HRS/ATN development whereas HRS mortality did not get affected with infection related parameters Longer duration of hospitalization, higher CTP & MELD score,male gender, presence of HE and hypotension with inotropic support requirement correlated significantly with response to terlipressin on univariate analysis. Presence of hypotension requiring inotropic support was the only factor on multivariate analysis to correlate with terlipressin non response. Development of HRS is associated with significantly reduced survival than other types of AKI in cirrhotics with especially dismal survival in terlipressin non responders. The terlipressin response rate in our cohort was 44%. Development of hypotension with inotropic requirement was the single most important predictor of terlipressin non response." @default.
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- W1452391417 date "2015-07-01" @default.
- W1452391417 modified "2023-10-16" @default.
- W1452391417 title "Predictors of Response and Outcome to Terlipressin in Patients With Hepatorenal Syndrome" @default.
- W1452391417 doi "https://doi.org/10.1016/j.cgh.2015.04.036" @default.
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