Comparison of Terlipressin Plus Human Albumin with Norepineprine Plus Human Albumen in Hepatorenal Renal Syndrome

Abstract

Aim: to evaluate the efficacy of norepinephrine plus albuman versus terlipressin plus albumin in the manage-ment of patients with type 1 HRS. Study Design: Randomized prospective study. Place and duration: medical unit of Nishter Hospital Multan from 10th June 2019 to 9th June 2020. Methodology: This study included 80 patients with type 1 HRS. Patients were randomized into two groups to re-ceive norepinephrine plus albumin or terlipressin plus albumin. Renal functions such as serum creatinine, cre-atinine clearance and urine output were observed in both the groups, for baseline and after 15 days. The out-comes assessed were as follows: reversal of HRS, kidney functions, survival rate at day 30. SPSS version 23 was used for data analysis. Results: Renal analysis of terlipressin and norepinephrine was noted as 17.5% and 30%, respectively. Child-pugh score and APACHE II score of terlipressin group was 10.73±2.01 and 22.94±10.05. Child-pugh score and APACHE II score of norepinephrine group was 9.03±2.25 and 25.39±9.87. Conclusion: Norepinephrine in combination with albumin is as effective as terlipressin in combination with albumin when used for the man-agement of hepatorenal syndrome (HRS) type 1. But easy availability and cheap rate of norepinephrine makes it alternative of terlipressin. Keywords: norepinephrine, hepatorenal syndrome, terlipressin, patient outcome