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Terlipressin and gelafundin : safe therapy of hepatorenal syndrome

Saner, F ; Kavuk, I ; Lang, H ; Biglarnia, R LU orcid ; Frühauf, N R ; Schäfers, R F ; Malagó, M and Broelsch, C E (2004) In European Journal of Medical Research 9(2). p.78-82
Abstract

BACKGROUND AND AIM: Hepatorenal syndrome (HRS) occurs in about 20 % of patients with liver cirrhosis and ascites and is characterized by intensive renal vasoconstriction, low glomerular filtration rate but preserved tubular function and normal renal histology. The potential of terlipressin and albumin to reverse HRS after a time period of 14 days has already been shown. However, intravenous albumin is expensive (approximately 25 per 50 ml 20% albumin in Germany) and has limited availability in some settings. Therefore we used an artificial plasma substitute, Gelatinepolysuccinat, which is less expensive (approximately 12 per 500 ml). The aim of our present study was to examine the effects of terlipressin and Gelatinepolysuccinat on... (More)

BACKGROUND AND AIM: Hepatorenal syndrome (HRS) occurs in about 20 % of patients with liver cirrhosis and ascites and is characterized by intensive renal vasoconstriction, low glomerular filtration rate but preserved tubular function and normal renal histology. The potential of terlipressin and albumin to reverse HRS after a time period of 14 days has already been shown. However, intravenous albumin is expensive (approximately 25 per 50 ml 20% albumin in Germany) and has limited availability in some settings. Therefore we used an artificial plasma substitute, Gelatinepolysuccinat, which is less expensive (approximately 12 per 500 ml). The aim of our present study was to examine the effects of terlipressin and Gelatinepolysuccinat on renal function and hemodynamics in a time period of six days.

METHODS AND PATIENTS: Seven consecutive patients with cirrhosis and hepatorenal syndrome were included in a pilot study of terlipressin (6 mg /24 h iv) therapy associated with i.v. Gelatinepolysuccinat (Gelafundin 4% Infusionslösung, Company Braun, Mw: 30 000 D).

RESULTS: In five of the seven patients treatment was associated with a marked reduction of serum creatinine after six days (3.85 +/- 0.44 mg/dl vs.1.9 +/- 0.32 mg/dl; p< 0.018). Creatinine clearance improved (20 +/- 8.8 ml/min vs. 43 +/- 11.7 ml/min; p<0.12). There was a remarkable improvement in circulatory function in all patients, with an increase in mean arterial pressure (58+/-4.4 mmHg vs. 75 +/- 4.5 mmHg, p< 0.001). No patient developed signs of intestinal, myocardial or distal ischemia.

CONCLUSIONS: Terlipressin and Gelatinepolysuccinat appear to be a safe and effective treatment of hepatorenal syndrome.

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author
; ; ; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
keywords
Antihypertensive Agents/therapeutic use, Creatinine/blood, Gelatin/administration & dosage, Glomerular Filtration Rate/drug effects, Hemodynamics/drug effects, Hepatorenal Syndrome/blood, Humans, Injections, Intravenous, Kidney/drug effects, Kidney Function Tests, Lypressin/analogs & derivatives, Pilot Projects, Plasma Substitutes/administration & dosage, Terlipressin, Treatment Outcome
in
European Journal of Medical Research
volume
9
issue
2
pages
5 pages
publisher
BioMed Central (BMC)
external identifiers
  • scopus:5444271322
  • pmid:15090293
ISSN
0949-2321
language
English
LU publication?
no
id
7c97ec9b-e0e6-4215-9a2f-f9e8c0906146
date added to LUP
2025-12-17 14:25:15
date last changed
2025-12-19 02:25:42
@article{7c97ec9b-e0e6-4215-9a2f-f9e8c0906146,
  abstract     = {{<p>BACKGROUND AND AIM: Hepatorenal syndrome (HRS) occurs in about 20 % of patients with liver cirrhosis and ascites and is characterized by intensive renal vasoconstriction, low glomerular filtration rate but preserved tubular function and normal renal histology. The potential of terlipressin and albumin to reverse HRS after a time period of 14 days has already been shown. However, intravenous albumin is expensive (approximately 25 per 50 ml 20% albumin in Germany) and has limited availability in some settings. Therefore we used an artificial plasma substitute, Gelatinepolysuccinat, which is less expensive (approximately 12 per 500 ml). The aim of our present study was to examine the effects of terlipressin and Gelatinepolysuccinat on renal function and hemodynamics in a time period of six days.</p><p>METHODS AND PATIENTS: Seven consecutive patients with cirrhosis and hepatorenal syndrome were included in a pilot study of terlipressin (6 mg /24 h iv) therapy associated with i.v. Gelatinepolysuccinat (Gelafundin 4% Infusionslösung, Company Braun, Mw: 30 000 D).</p><p>RESULTS: In five of the seven patients treatment was associated with a marked reduction of serum creatinine after six days (3.85 +/- 0.44 mg/dl vs.1.9 +/- 0.32 mg/dl; p&lt; 0.018). Creatinine clearance improved (20 +/- 8.8 ml/min vs. 43 +/- 11.7 ml/min; p&lt;0.12). There was a remarkable improvement in circulatory function in all patients, with an increase in mean arterial pressure (58+/-4.4 mmHg vs. 75 +/- 4.5 mmHg, p&lt; 0.001). No patient developed signs of intestinal, myocardial or distal ischemia.</p><p>CONCLUSIONS: Terlipressin and Gelatinepolysuccinat appear to be a safe and effective treatment of hepatorenal syndrome.</p>}},
  author       = {{Saner, F and Kavuk, I and Lang, H and Biglarnia, R and Frühauf, N R and Schäfers, R F and Malagó, M and Broelsch, C E}},
  issn         = {{0949-2321}},
  keywords     = {{Antihypertensive Agents/therapeutic use; Creatinine/blood; Gelatin/administration & dosage; Glomerular Filtration Rate/drug effects; Hemodynamics/drug effects; Hepatorenal Syndrome/blood; Humans; Injections, Intravenous; Kidney/drug effects; Kidney Function Tests; Lypressin/analogs & derivatives; Pilot Projects; Plasma Substitutes/administration & dosage; Terlipressin; Treatment Outcome}},
  language     = {{eng}},
  month        = {{02}},
  number       = {{2}},
  pages        = {{78--82}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{European Journal of Medical Research}},
  title        = {{Terlipressin and gelafundin : safe therapy of hepatorenal syndrome}},
  volume       = {{9}},
  year         = {{2004}},
}