Kidney Week

Abstract: FR-PO093

Impact of Baseline Kidney Function in Determining the Efficacy of Terlipressin in Patients with Hepatorenal Syndrome

Session Information

• AKI: Diagnosis and Outcomes
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 102 AKI: Clinical, Outcomes, and Trials

Authors

• Chae, Seung Yun, The Catholic University of Korea Seoul St Mary's Hospital, Seoul, Seo-cho gu, Korea (the Republic of)

Seung Yun Chae, MD, PhD

• Kim, Young soo, The Catholic University of Korea Uijeongbu St Mary's Hospital, Uijeongbu, Gyeonggi-do, Korea (the Republic of)

Young soo Kim, MD, PhD

• Kim, Yaeni, The Catholic University of Korea Seoul St Mary's Hospital, Seoul, Seo-cho gu, Korea (the Republic of)

Yaeni Kim, MD, PhD

Background

We examined the influence of estimated glomerular filtration rate (eGFR) on survival outcomes in patients with hepatorenal syndrome undergoing treatment with terlipressin and albumin. This therapeutic strategy, acknowledged for its ability to improve survival rates and extend the waiting period for liver transplantation, is constrained by korean reimbursement policies. These policies necessitate a diagnosis of HRS-acute kidney injury (AKI) based on serum creatinine levels, thereby restricting the treatment to patients with markedly advanced conditions.

Methods

We performed a retrospective analysis of 130 patients diagnosed with hepatorenal syndrome who were treated with terlipressin and albumin. Our investigation focused on identifying factors linked to liver transplantation-free survival.

Results

In our study, which included patients with an average age of 56 and predominantly male (92%), liver failure was mainly caused by alcohol (71.5%), followed by hepatitis B (14.6%), non-alcoholic fatty liver disease (8.5%), hepatitis C (3.1%), and autoimmune hepatitis (2.3%). The median liver transplantation-free survival was 12 days. Patients with a MELD score greater than 30 had worse survival rates compared to those with a score less than 30. Additionally, individuals with an eGFR above 20 ml/min/1.73 m² showed better survival rates than those with an eGFR below 20. Logistic regression analysis identified eGFR below 20 and MELD scores above 30 as significant risk factors for reduced survival in both univariate and multivariate analyses.

Conclusion

Our study found that an increase in eGFR above 20 ml/min/1.73 m², along with a lower MELD score, correlated with better liver transplantation-free survival. This suggests that using eGFR rather than creatinine (Cr) as a criterion for terlipressin treatment may result in greater improvements in eGFR and thereby enhance survival outcomes.

LT-Free Survival Curves of Groups Divided by the eGFR cutoff of 20 ml/min/1.73 m²