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Digestive Diseases and Sciences

, Volume 52, Issue 3, pp 742–748 | Cite as

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

  • Eric Esrailian
  • Eugene R. Pantangco
  • Namgyal L. Kyulo
  • Ke-Qin Hu
  • Bruce A. Runyon
Original Article

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

Cirrhosis Renal failure Hepatorenal syndrome Ascites Portal hypertension 

Notes

Acknowledgment

This paper is dedicated to Dr. Telfer B. Reynolds, who spent his distinguished career studying, teaching about, and caring for patients with liver failure and fluid and electrolyte imbalance. His influence on the authors and on this study cannot be quantified.

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Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Eric Esrailian
    • 1
  • Eugene R. Pantangco
    • 1
  • Namgyal L. Kyulo
    • 2
  • Ke-Qin Hu
    • 2
  • Bruce A. Runyon
    • 1
    • 3
  1. 1.University of Southern California Liver Unit at Rancho Los Amigos Medical CenterDowneyUSA
  2. 2.Division of Gastroenterology/HepatologyUniversity of CaliforniaIrvine, OrangeUSA
  3. 3.Liver ServiceLoma Linda University Medical CenterLoma LindaUSA

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