Digestive Diseases and Sciences

, Volume 52, Issue 3, pp 742–748

Octreotide/Midodrine Therapy Significantly Improves Renal Function and 30-Day Survival in Patients with Type 1 Hepatorenal Syndrome

Authors

  • Eric Esrailian
    • University of Southern California Liver Unit at Rancho Los Amigos Medical Center
  • Eugene R. Pantangco
    • University of Southern California Liver Unit at Rancho Los Amigos Medical Center
  • Namgyal L. Kyulo
    • Division of Gastroenterology/HepatologyUniversity of California
  • Ke-Qin Hu
    • Division of Gastroenterology/HepatologyUniversity of California
    • University of Southern California Liver Unit at Rancho Los Amigos Medical Center
    • Liver ServiceLoma Linda University Medical Center
Original Article

DOI: 10.1007/s10620-006-9312-0

Cite this article as:
Esrailian, E., Pantangco, E.R., Kyulo, N.L. et al. Dig Dis Sci (2007) 52: 742. doi:10.1007/s10620-006-9312-0

Abstract

Type 1 hepatorenal syndrome (HRS) can be a rapidly fatal consequence of liver failure. Recent studies have utilized vasoconstrictor therapies to combat splanchnic vasodilatation. We aimed to evaluate the efficacy of a promising treatment for type 1 HRS. We compared the survival of HRS patients who received octreotide and midodrine treatment at Rancho Los Amigos Medical Center with a concurrent untreated control group of HRS patients who did not receive this treatment. Of the 81 patients, 60 were treated with octreotide/midodrine and 21 were controls. Mortality was significantly lower in the treatment group (43%) than in the controls (71%; P < 0.05). Furthermore, 24 study patients (40%) had a sustained reduction of serum creatinine compared with only 2 controls (10%; P < 0.05). This large retrospective study suggests that octreotide/midodrine treatment appears to improve 30-day survival. A randomized, controlled trial is the next important step toward evaluating this treatment modality.

Keywords

CirrhosisRenal failureHepatorenal syndromeAscitesPortal hypertension

Copyright information

© Springer Science+Business Media, Inc. 2006