特利加压素治疗成人肝肾综合征急性肾损伤(HRS-AKI)。

IF 3.8 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Expert Review of Gastroenterology & Hepatology Pub Date : 2023-07-01 Epub Date: 2023-11-23 DOI:10.1080/17474124.2023.2273494
Anand V Kulkarni, Jason Lee, K Rajender Reddy
{"title":"特利加压素治疗成人肝肾综合征急性肾损伤(HRS-AKI)。","authors":"Anand V Kulkarni, Jason Lee, K Rajender Reddy","doi":"10.1080/17474124.2023.2273494","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Kidney is the most common extra-hepatic organ involved in patients with advanced liver cirrhosis and acute-on-chronic liver failure. Hepatorenal syndrome-acute kidney injury (HRS-AKI) accounts for most hospitalizations, and liver transplantation (LT) remains the ultimate and long-term treatment in such patients. However, HRS-AKI, being a functional renal failure, has a fair chance of reversal, and as such, patients who achieve reversal of HRS-AKI have better outcomes post-LT.</p><p><strong>Areas covered: </strong>In this review, we discuss the pharmacokinetics, pharmacodynamics and evidence to support the use of terlipressin in HRS-AKI while we also address predictors of response and the associated adverse events. Further, we discuss the role of terlipressin in the context of LT.</p><p><strong>Expert opinion: </strong>The recommended treatment for HRS-AKI reversal includes a vasoconstrictor in addition to volume expansion with albumin. The three vasoconstrictor regimens generally used to treat HRS-AKI include octreotide plus midodrine, noradrenaline, and terlipressin. Of these, terlipressin is a widely used drug and has been recently approved by US Food and Drug Administration (USFDA) for HRS-AKI. Terlipressin is the most effective drug for HRS-AKI reversal and is associated with a decreased need for renal replacement therapy pre- and post-transplant. Furthermore, terlipressin responders have improved transplant-free and post-transplant survival.</p>","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1067-1079"},"PeriodicalIF":3.8000,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Terlipressin in the management of adults with hepatorenal syndrome-acute kidney injury (HRS-AKI).\",\"authors\":\"Anand V Kulkarni, Jason Lee, K Rajender Reddy\",\"doi\":\"10.1080/17474124.2023.2273494\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Kidney is the most common extra-hepatic organ involved in patients with advanced liver cirrhosis and acute-on-chronic liver failure. Hepatorenal syndrome-acute kidney injury (HRS-AKI) accounts for most hospitalizations, and liver transplantation (LT) remains the ultimate and long-term treatment in such patients. However, HRS-AKI, being a functional renal failure, has a fair chance of reversal, and as such, patients who achieve reversal of HRS-AKI have better outcomes post-LT.</p><p><strong>Areas covered: </strong>In this review, we discuss the pharmacokinetics, pharmacodynamics and evidence to support the use of terlipressin in HRS-AKI while we also address predictors of response and the associated adverse events. Further, we discuss the role of terlipressin in the context of LT.</p><p><strong>Expert opinion: </strong>The recommended treatment for HRS-AKI reversal includes a vasoconstrictor in addition to volume expansion with albumin. The three vasoconstrictor regimens generally used to treat HRS-AKI include octreotide plus midodrine, noradrenaline, and terlipressin. Of these, terlipressin is a widely used drug and has been recently approved by US Food and Drug Administration (USFDA) for HRS-AKI. Terlipressin is the most effective drug for HRS-AKI reversal and is associated with a decreased need for renal replacement therapy pre- and post-transplant. Furthermore, terlipressin responders have improved transplant-free and post-transplant survival.</p>\",\"PeriodicalId\":12257,\"journal\":{\"name\":\"Expert Review of Gastroenterology & Hepatology\",\"volume\":\" \",\"pages\":\"1067-1079\"},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2023-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Expert Review of Gastroenterology & Hepatology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/17474124.2023.2273494\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/11/23 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Expert Review of Gastroenterology & Hepatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/17474124.2023.2273494","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/11/23 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

引言:肾脏是晚期肝硬化和急慢性肝功能衰竭患者最常见的肝外器官。肝肾综合征急性肾损伤(HRS-AKI)是大多数住院患者的原因,肝移植(LT)仍然是此类患者的最终和长期治疗方法。然而,HRS-AKI作为一种功能性肾衰竭,有相当大的逆转机会,因此,HRS-AKI逆转的患者在LT后有更好的结果。涵盖的领域:在这篇综述中,我们讨论了支持在HRS-AKI中使用特利加压素的药代动力学、药效学和证据,同时我们还讨论了反应和相关不良事件的预测因素。此外,我们还讨论了特利加压素在LT中的作用。专家意见:推荐的HRS-AKI逆转治疗方法除了用白蛋白扩大体积外,还包括血管收缩剂。通常用于治疗HRS-AKI的三种血管收缩剂方案包括奥曲肽加米多林、去甲肾上腺素和特利加压素。其中,特利加压素是一种广泛使用的药物,最近已被美国食品药品监督管理局(USFDA)批准用于HRS-AKI。特利加压素是逆转HRS-AKI最有效的药物,与移植前后对肾脏替代治疗的需求减少有关。此外,特利加压素应答者提高了无移植和移植后的存活率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Terlipressin in the management of adults with hepatorenal syndrome-acute kidney injury (HRS-AKI).

Introduction: Kidney is the most common extra-hepatic organ involved in patients with advanced liver cirrhosis and acute-on-chronic liver failure. Hepatorenal syndrome-acute kidney injury (HRS-AKI) accounts for most hospitalizations, and liver transplantation (LT) remains the ultimate and long-term treatment in such patients. However, HRS-AKI, being a functional renal failure, has a fair chance of reversal, and as such, patients who achieve reversal of HRS-AKI have better outcomes post-LT.

Areas covered: In this review, we discuss the pharmacokinetics, pharmacodynamics and evidence to support the use of terlipressin in HRS-AKI while we also address predictors of response and the associated adverse events. Further, we discuss the role of terlipressin in the context of LT.

Expert opinion: The recommended treatment for HRS-AKI reversal includes a vasoconstrictor in addition to volume expansion with albumin. The three vasoconstrictor regimens generally used to treat HRS-AKI include octreotide plus midodrine, noradrenaline, and terlipressin. Of these, terlipressin is a widely used drug and has been recently approved by US Food and Drug Administration (USFDA) for HRS-AKI. Terlipressin is the most effective drug for HRS-AKI reversal and is associated with a decreased need for renal replacement therapy pre- and post-transplant. Furthermore, terlipressin responders have improved transplant-free and post-transplant survival.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Expert Review of Gastroenterology & Hepatology
Expert Review of Gastroenterology & Hepatology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
6.80
自引率
2.60%
发文量
86
审稿时长
6-12 weeks
期刊介绍: The enormous health and economic burden of gastrointestinal disease worldwide warrants a sharp focus on the etiology, epidemiology, prevention, diagnosis, treatment and development of new therapies. By the end of the last century we had seen enormous advances, both in technologies to visualize disease and in curative therapies in areas such as gastric ulcer, with the advent first of the H2-antagonists and then the proton pump inhibitors - clear examples of how advances in medicine can massively benefit the patient. Nevertheless, specialists face ongoing challenges from a wide array of diseases of diverse etiology.
期刊最新文献
Cellular senescence and its pathogenic and therapeutic implications in autoimmune hepatitis. Implications of the microbiome after pancreatic cancer resection with regards to morbidity & mortality. Diagnosing and managing gastroparesis - where are we now? Interrupting inflammatory bowel disease therapy: why, who, when and how to consider medication holidays. Therapeutic drug monitoring in inflammatory bowel disease: recent developments.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1