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• W2891883452 abstract "Background Hepatorenal syndrome is defined as renal failure in people with cirrhosis in the absence of other causes. In addition to supportive treatment such as albumin to restore fluid balance, the other potential treatments include systemic vasoconstrictor drugs (such as vasopressin analogues or noradrenaline), renal vasodilator drugs (such as dopamine), transjugular intrahepatic portosystemic shunt (TIPS), and liver support with molecular adsorbent recirculating system (MARS). There is uncertainty over the best treatment regimen for hepatorenal syndrome. Objectives To compare the benefits and harms of different treatments for hepatorenal syndrome in people with decompensated liver cirrhosis. Search methods We searched CENTRAL, MEDLINE, Embase, Science Citation Index Expanded, World Health Organization International Clinical Trials Registry Platform, and trial registers until December 2018 to identify randomised clinical trials on hepatorenal syndrome in people with cirrhosis. Selection criteria We included only randomised clinical trials (irrespective of language, blinding, or publication status) in adults with cirrhosis and hepatorenal syndrome. We excluded randomised clinical trials in which participants had previously undergone liver transplantation. Data collection and analysis Two authors independently identified eligible trials and collected data. The outcomes for this review included mortality, serious adverse events, any adverse events, resolution of hepatorenal syndrome, liver transplantation, and other decompensation events. We performed a network meta‐analysis with OpenBUGS using Bayesian methods and calculated the odds ratio (OR), rate ratio, hazard ratio (HR), and mean difference (MD) with 95% credible intervals (CrI) based on an available‐case analysis, according to National Institute of Health and Care Excellence Decision Support Unit guidance. Main results We included a total of 25 trials (1263 participants; 12 interventions) in the review. Twenty‐three trials (1185 participants) were included in one or more outcomes. All the trials but two were at high risk of bias, and all the evidence was of low or very low certainty. The trials included participants with liver cirrhosis of varied aetiologies as well as a mixture of type I hepatorenal syndrome only, type II hepatorenal syndrome only, or people with both type I and type II hepatorenal syndrome. Participant age ranged from 42 to 60 years, and the proportion of females ranged from 5.8% to 61.5% in the trials that reported this information. The follow‐up in the trials ranged from one week to six months. Overall, 59% of participants died during this period and about 35% of participants recovered from hepatorenal syndrome. The most common interventions compared were albumin plus terlipressin, albumin plus noradrenaline, and albumin alone. There was no evidence of a difference in mortality (22 trials; 1153 participants) at maximal follow‐up between the different interventions. None of the trials reported health‐related quality of life. There was no evidence of differences in the proportion of people with serious adverse events (three trials; 428 participants), number of participants with serious adverse events per participant (two trials; 166 participants), proportion of participants with any adverse events (four trials; 402 participants), the proportion of people who underwent liver transplantation at maximal follow‐up (four trials; 342 participants), or other features of decompensation at maximal follow‐up (one trial; 466 participants). Five trials (293 participants) reported number of any adverse events, and five trials (219 participants) reported treatment costs. Albumin plus noradrenaline had fewer numbers of adverse events per participant (rate ratio 0.51, 95% CrI 0.28 to 0.87). Eighteen trials (1047 participants) reported recovery from hepatorenal syndrome (as per definition of hepatorenal syndrome). In terms of recovery from hepatorenal syndrome, in the direct comparisons, albumin plus midodrine plus octreotide and albumin plus octreotide had lower recovery from hepatorenal syndrome than albumin plus terlipressin (HR 0.04; 95% CrI 0.00 to 0.25 and HR 0.26, 95% CrI 0.07 to 0.80 respectively). There was no evidence of differences between the groups in any of the other direct comparisons. In the network meta‐analysis, albumin and albumin plus midodrine plus octreotide had lower recovery from hepatorenal syndrome compared with albumin plus terlipressin. Funding: two trials were funded by pharmaceutical companies; five trials were funded by parties who had no vested interest in the results of the trial; and 18 trials did not report the source of funding. Authors' conclusions Based on very low‐certainty evidence, there is no evidence of benefit or harm of any of the interventions for hepatorenal syndrome with regards to the following outcomes: all‐cause mortality, serious adverse events (proportion), number of serious adverse events per participant, any adverse events (proportion), liver transplantation, or other decompensation events. Low‐certainty evidence suggests that albumin plus noradrenaline had fewer 'any adverse events per participant' than albumin plus terlipressin. Low‐ or very low‐certainty evidence also found that albumin plus midodrine plus octreotide and albumin alone had lower recovery from hepatorenal syndrome compared with albumin plus terlipressin. Future randomised clinical trials should be adequately powered; employ blinding, avoid post‐randomisation dropouts or planned cross‐overs (or perform an intention‐to‐treat analysis); and report clinically important outcomes such as mortality, health‐related quality of life, adverse events, and recovery from hepatorenal syndrome. Albumin plus noradrenaline and albumin plus terlipressin appear to be the interventions that should be compared in future trials." @default.
• W2891883452 created "2018-09-27" @default.
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• W2891883452 date "2019-09-12" @default.
• W2891883452 modified "2023-09-30" @default.
• W2891883452 title "Treatment for hepatorenal syndrome in people with decompensated liver cirrhosis: a network meta-analysis" @default.
• W2891883452 cites W1269360376 @default.
• W2891883452 cites W1508690770 @default.
• W2891883452 cites W1534719948 @default.
• W2891883452 cites W1552630832 @default.
• W2891883452 cites W1556794428 @default.
• W2891883452 cites W1557856026 @default.
• W2891883452 cites W1570538350 @default.
• W2891883452 cites W1581349344 @default.
• W2891883452 cites W1617328014 @default.
• W2891883452 cites W172107136 @default.
• W2891883452 cites W1770193682 @default.
• W2891883452 cites W1864045238 @default.
• W2891883452 cites W1899691766 @default.
• W2891883452 cites W1917372364 @default.
• W2891883452 cites W1964489041 @default.
• W2891883452 cites W1964502734 @default.
• W2891883452 cites W1967340042 @default.
• W2891883452 cites W1967589221 @default.
• W2891883452 cites W1970752949 @default.
• W2891883452 cites W1971895240 @default.
• W2891883452 cites W1971969855 @default.
• W2891883452 cites W1975116042 @default.
• W2891883452 cites W1982355832 @default.
• W2891883452 cites W1987305426 @default.
• W2891883452 cites W1998341790 @default.
• W2891883452 cites W2007181621 @default.
• W2891883452 cites W2008730819 @default.
• W2891883452 cites W2010589340 @default.
• W2891883452 cites W2010699829 @default.
• W2891883452 cites W2011199481 @default.
• W2891883452 cites W2011458442 @default.
• W2891883452 cites W2011932878 @default.
• W2891883452 cites W2025458886 @default.
• W2891883452 cites W2029276570 @default.
• W2891883452 cites W2032310250 @default.
• W2891883452 cites W2036652612 @default.
• W2891883452 cites W2045620941 @default.
• W2891883452 cites W2051265236 @default.
• W2891883452 cites W2051278614 @default.
• W2891883452 cites W2061489021 @default.
• W2891883452 cites W2064739831 @default.
• W2891883452 cites W2065384164 @default.
• W2891883452 cites W2073024831 @default.
• W2891883452 cites W2077653789 @default.
• W2891883452 cites W2081737317 @default.
• W2891883452 cites W2081963999 @default.
• W2891883452 cites W2085803274 @default.
• W2891883452 cites W2088870244 @default.
• W2891883452 cites W2091651530 @default.
• W2891883452 cites W2091808438 @default.
• W2891883452 cites W2094598763 @default.
• W2891883452 cites W2101250222 @default.
• W2891883452 cites W2104675861 @default.
• W2891883452 cites W2106051200 @default.
• W2891883452 cites W2108696783 @default.
• W2891883452 cites W2110616090 @default.
• W2891883452 cites W2113711610 @default.
• W2891883452 cites W2117294447 @default.
• W2891883452 cites W2120179295 @default.
• W2891883452 cites W2121796373 @default.
• W2891883452 cites W2124273275 @default.
• W2891883452 cites W2129821518 @default.
• W2891883452 cites W2131701504 @default.
• W2891883452 cites W2131903288 @default.
• W2891883452 cites W2133275424 @default.
• W2891883452 cites W2134338262 @default.
• W2891883452 cites W2143010085 @default.
• W2891883452 cites W2144625636 @default.
• W2891883452 cites W2148308926 @default.
• W2891883452 cites W2155798268 @default.
• W2891883452 cites W2157556100 @default.
• W2891883452 cites W2160795579 @default.
• W2891883452 cites W2161817962 @default.
• W2891883452 cites W2163743044 @default.
• W2891883452 cites W2164601307 @default.
• W2891883452 cites W2166023752 @default.
• W2891883452 cites W2254448168 @default.
• W2891883452 cites W2282617728 @default.
• W2891883452 cites W2283978743 @default.
• W2891883452 cites W2316788154 @default.
• W2891883452 cites W2394622771 @default.

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