P-73 NORADRENALINE IN THE TREATMENT OF HEPATORENAL SYNDROME TYPE AKI: RESULTS IN NON-ICU HOSPITAL SETTING
Conflict of interest: No Introduction and Objectives: Hepatorenal syndrome acute kidney injury (HRS-AKI) is a phenotype of acute kidney injury that occurs in patients with decompensated liver cirrhosis owing to circulatory dysfunction and systemic inflammation. To describe the clinical characteristi...
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Elsevier
2024-12-01
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| Series: | Annals of Hepatology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268124004708 |
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| author | Zuly Plácido Damián Javier Diaz Ferrer Giancarlo Perez Lazo |
| author_facet | Zuly Plácido Damián Javier Diaz Ferrer Giancarlo Perez Lazo |
| author_sort | Zuly Plácido Damián |
| collection | DOAJ |
| description | Conflict of interest: No Introduction and Objectives: Hepatorenal syndrome acute kidney injury (HRS-AKI) is a phenotype of acute kidney injury that occurs in patients with decompensated liver cirrhosis owing to circulatory dysfunction and systemic inflammation. To describe the clinical characteristics, treatment responses, and outcomes of patients who developed HRS-AKI in a non-ICU hospital setting. Patients / Materials and Methods: Case series analysis. The electronic medical records were reviewed. Stata v18.0 was used for descriptive analysis. Results and Discussion: Sixteen patients with cirrhosis admitted to a non-ICU hospital area who developed HRS-AKI were identified. The median age was 64.5 years (interquartile range [IQR]: 57-66.5). Sixty-eight percent had MASLD etiology. Seventy-five percent of patients were classified as CHILD C, with a median MELD-Na score of 26 points (IQR: 19-31). At the time of HRS-AKI diagnosis, the mean duration of prior intravenous albumin administration was 2.9 days.All patients underwent central venous catheterization and hemodynamic monitoring. Eighty-eight percent (14) of the patients had resolved HRS-AKI, although two patients developed acute respiratory failure as a complication. The overall hospital mortality rate was 43.8% (n=7), HRS-AKI recurrence at 30 days was 35.7% (5/14), and time to recurrence was approximately 17 days. Conclusions: HRS-AKI is a critical condition in patients with cirrhosis treated with vasopressors and intravenous albumin. In this case series, the use of norepinephrine outside the ICU proved to be effective and safe; however, the high recurrence and mortality rates suggest that it should be considered as a bridge therapy to liver transplantation. |
| format | Article |
| id | doaj-art-3f986b384c384d5cb0749e8550fb5254 |
| institution | Kabale University |
| issn | 1665-2681 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj-art-3f986b384c384d5cb0749e8550fb52542024-12-07T08:25:43ZengElsevierAnnals of Hepatology1665-26812024-12-0129101687P-73 NORADRENALINE IN THE TREATMENT OF HEPATORENAL SYNDROME TYPE AKI: RESULTS IN NON-ICU HOSPITAL SETTINGZuly Plácido Damián0Javier Diaz Ferrer1Giancarlo Perez Lazo2HOSPITAL NACIONAL EDGARDO REBAGLIATI MARTINS, Lima, PerúHOSPITAL NACIONAL EDGARDO REBAGLIATI MARTINS, Lima, PerúHOSPITAL NACIONAL GUILLERMO ALMENARA IRIGOYEN, Lima, PerúConflict of interest: No Introduction and Objectives: Hepatorenal syndrome acute kidney injury (HRS-AKI) is a phenotype of acute kidney injury that occurs in patients with decompensated liver cirrhosis owing to circulatory dysfunction and systemic inflammation. To describe the clinical characteristics, treatment responses, and outcomes of patients who developed HRS-AKI in a non-ICU hospital setting. Patients / Materials and Methods: Case series analysis. The electronic medical records were reviewed. Stata v18.0 was used for descriptive analysis. Results and Discussion: Sixteen patients with cirrhosis admitted to a non-ICU hospital area who developed HRS-AKI were identified. The median age was 64.5 years (interquartile range [IQR]: 57-66.5). Sixty-eight percent had MASLD etiology. Seventy-five percent of patients were classified as CHILD C, with a median MELD-Na score of 26 points (IQR: 19-31). At the time of HRS-AKI diagnosis, the mean duration of prior intravenous albumin administration was 2.9 days.All patients underwent central venous catheterization and hemodynamic monitoring. Eighty-eight percent (14) of the patients had resolved HRS-AKI, although two patients developed acute respiratory failure as a complication. The overall hospital mortality rate was 43.8% (n=7), HRS-AKI recurrence at 30 days was 35.7% (5/14), and time to recurrence was approximately 17 days. Conclusions: HRS-AKI is a critical condition in patients with cirrhosis treated with vasopressors and intravenous albumin. In this case series, the use of norepinephrine outside the ICU proved to be effective and safe; however, the high recurrence and mortality rates suggest that it should be considered as a bridge therapy to liver transplantation.http://www.sciencedirect.com/science/article/pii/S1665268124004708 |
| spellingShingle | Zuly Plácido Damián Javier Diaz Ferrer Giancarlo Perez Lazo P-73 NORADRENALINE IN THE TREATMENT OF HEPATORENAL SYNDROME TYPE AKI: RESULTS IN NON-ICU HOSPITAL SETTING Annals of Hepatology |
| title | P-73 NORADRENALINE IN THE TREATMENT OF HEPATORENAL SYNDROME TYPE AKI: RESULTS IN NON-ICU HOSPITAL SETTING |
| title_full | P-73 NORADRENALINE IN THE TREATMENT OF HEPATORENAL SYNDROME TYPE AKI: RESULTS IN NON-ICU HOSPITAL SETTING |
| title_fullStr | P-73 NORADRENALINE IN THE TREATMENT OF HEPATORENAL SYNDROME TYPE AKI: RESULTS IN NON-ICU HOSPITAL SETTING |
| title_full_unstemmed | P-73 NORADRENALINE IN THE TREATMENT OF HEPATORENAL SYNDROME TYPE AKI: RESULTS IN NON-ICU HOSPITAL SETTING |
| title_short | P-73 NORADRENALINE IN THE TREATMENT OF HEPATORENAL SYNDROME TYPE AKI: RESULTS IN NON-ICU HOSPITAL SETTING |
| title_sort | p 73 noradrenaline in the treatment of hepatorenal syndrome type aki results in non icu hospital setting |
| url | http://www.sciencedirect.com/science/article/pii/S1665268124004708 |
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