Terlipressin May Decrease In-Hospital Mortality of Cirrhotic Patients with Acute Gastrointestinal Bleeding and Renal Dys
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ORIGINAL RESEARCH
Terlipressin May Decrease In-Hospital Mortality of Cirrhotic Patients with Acute Gastrointestinal Bleeding and Renal Dysfunction: A Retrospective Multicenter Observational Study Xiangbo Xu . Bang Liu . Su Lin . Bimin Li . Yunhai Wu . Yiling Li . Qiang Zhu . Yida Yang . Shanhong Tang . Fanping Meng . Yu Chen . Shanshan Yuan . Lichun Shao . Mauro Bernardi . Eric M. Yoshida . Xingshun Qi Received: June 20, 2020 Ó The Author(s) 2020
ABSTRACT Background: Acute gastrointestinal bleeding (GIB) rapidly reduces effective blood volume, thereby precipitating acute kidney injury (AKI). Terlipressin, which can induce splanchnic Xiangbo Xu, Bang Liu, Su Lin, and Bimin Li equally contributed to this article.
Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12771014. Electronic Supplementary Material The online version of this article (https://doi.org/10.1007/s12325020-01466-z) contains supplementary material, which is available to authorized users. X. Xu X. Qi (&) Department of Gastroenterology, General Hospital of Northern Theater Command (Formerly Called General Hospital of Shenyang Military Area), Shenyang, China e-mail: [email protected]
vasoconstriction and increase renal perfusion, has been recommended for acute GIB and hepatorenal syndrome in liver cirrhosis. Thus, we hypothesized that terlipressin might be beneficial for cirrhotic patients with acute GIB and renal impairment. Methods: In this Chinese multi-center study, 1644 cirrhotic patients with acute GIB were retrospectively enrolled. AKI was defined according to the International Club of Ascites (ICA) criteria. Renal dysfunction was defined as serum creatinine (sCr) [ 133 lmol/L at admission and/or any time point during hospitalization. Incidence of renal impairment and inhospital mortality were the primary end-points.
B. Li Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China Y. Wu Department of Critical Care Medicine, The Sixth People’s Hospital of Shenyang, Shenyang, China
B. Liu Department of Hepatobiliary Disease, Fuzong Clinical Medical College of Fujian Medical University & 900 Hospital of the Joint Logistics Team, Fuzhou, China
Y. Li Department of Gastroenterology, The First Affiliated Hospital of China Medical University, Shenyang, China
S. Lin Liver Research Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
Q. Zhu Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
Adv Ther
Results: The incidence of any stage ICA-AKI, ICA-AKI stages 1B, 2, and 3, and renal dysfunction in cirrhotic patients with acute GIB was 7.1%, 1.8%, and 5.0%, respectively. The inhospital mortality was significantly increased by renal dysfunction (14.5% vs. 2.2%, P \ 0.001) and ICA-AKI stages 1B, 2, and 3 (11.1% vs. 2.8%, P = 0.011), but not any stage ICA-AKI (5.7% vs. 2.7%, P = 0.083). The in-hospital mortality was significantly decreased by terlipressin in patients w
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