Real-World Use of Terlipressin in Cirrhosis and Acute Kidney Injury: Frequent Use Beyond Hepatorenal Syndrome

作者：Ann T., Adrià Juanola, Kavish R. Patidar, Anna Barone, Simone Incicco, Anand V. Kulkarni, Nipun Verma, Christian M. Lange, Qing Xie, Carlo Alessandria, Eira Cerda‐Reyes, Rakhi Maiwall, Jeong Han Kim, Sebastián Marciano, Alberto Queiróz Farias, Claudio Toledo, Silvia Nardelli, Julio Vorobioff, Juan Pablo Roblero, Thierry Thévenot, Mária Papp, Raoel Maan, Cristina Solé, Jacqueline Córdova‐Gallardo, Douglas A. Simonetto, Yasser Fouad, Lorenz Balcar, Sarah Raevens, Puria Nabilou, Paolo Caraceni, Manuela Merli, José Presa, Wim Laleman, Aleksander Krag, Tony Bruns, Gustavo Pereira, Ângelo Zambam de Mattos, Juan Pablo Arab, Brian J. Wentworth, Nadia Abdelaaty Abdelkader, Yu Jun Wong, Sung Eun Kim, Olivier Roux, R. Bart Takkenberg, Antonio Galante, Luciana Lofêgo Gonçalves, Nikolaos Pyrsopoulos, José Luis Pérez Hernández, Sumeet K. Asrani, Aldo Torre, Javier Díaz‐Ferrer, Eric S. Orman, Giovanni Perricone, Adrian Gadano, В. Т. Ивашкин, E Fassio, Mónica Marino, Vı́ctor Vargas, Liane Rabinowich, Pedro Montes, Abdulsemed Mohammed, Enrique V. Carrera, María Cecilia Cabrera Cabrejos, Marcos Girala, Hrishikesh Samant, João Madaleno, W. Ray Kim, Carlos Noronha Ferreira, Andrew S. Allegretti, Shiv Kumar Sarin, Pere Ginès, Paolo Angeli, Elsa Solà, Salvatore Piano, François Durand, Padaki Nagaraj Rao, Mithun Sharma, Luis Garrido-Trevino, Kim Minh Le, Dong Joon Kim, Ji Won Park, Rahul Kumar, Jessica Tan Yi-Lyn, Diego Fernando Abendaño Rivera, Karina Cazarin Chávez, Maria José Moreta, Alberto Calleri, Marco Tizzani, Nicolas Intagliata, Gabrielle Laskey, Luca Saverio Belli, Enrico Pompili, Marco Mattana, Safaa M. Abdelhalim, Caroline Marcondes Ferreira, Kamalpreet S. Hara, Paul Jamme, Maria Mercedes Cortese, Daniela Simian, Won-hyeok Choe, Stefanny Cornejo-Hernández, César Jiménez, Juliana Piedade, Mariana Ariel Herrera Islas, Silvina Tevez, Izabelle Venturini Signorelli, Zuly Plácido-Damián, Jesús Alejandro Ruiz-Manríquez, Enas Mohamed Soliman, Cristian Yamín Sánchez Sánchez, Zhujun Cao, Yaoxing Chen, Berta López-Sáez, Renato Palma-Fernández, Boglarka Balogh, Lise Lotte Gluud, Iván Bello, Delphine Weil-Verhoeven, Marina Maevskaya, Arka De, Andrea De Gottardi, Thomas Reiberger, Murat Harputluoglu, Stefania Gioia, Oliviero Riggio · 发表于：Clinical Gastroenterology and Hepatology · 年份：2025 · DOI：10.1016/j.cgh.2025.08.031 · 被引用次数：4 · 研究领域：Liver Disease and Transplantation、Sepsis Diagnosis and Treatment、Electrolyte and hormonal disorders

BACKGROUND & AIMS: Terlipressin is indicated to treat hepatorenal syndrome (HRS)-acute kidney injury (AKI) but is likely used outside this primary indication in clinical practice. We aimed to investigate real-world practice patterns on the use of terlipressin in AKI in cirrhosis. METHODS: International prospective study including patients hospitalized for decompensated cirrhosis. This was a subgroup analysis of patients who received terlipressin to treat AKI. Primary outcome was AKI resolution. Secondary outcomes were respiratory failure and 28-day mortality. RESULTS: Among 1456 patients with AKI, 243 (17%) received terlipressin. Terlipressin was predominantly administered as a continuous infusion (75%). The AKI phenotype was HRS-AKI in 50%, acute tubular necrosis (ATN) in 17%, hypovolemic in 25%, and other in 8%. AKI resolution occurred in 49% of the patients, and was lowest in ATN (29%), followed by HRS-AKI (51%) and hypovolemic (63%). ATN was independently associated with lack of AKI resolution (odds ratio, 2.77; 95% confidence interval, 1.24-6.54; P = .02). De novo respiratory failure occurred in 20% of patients. There were no significant differences in the amount of albumin received nor acute-on-chronic liver failure grade between those who did and did not develop respiratory failure. The presence of pneumonia independently predicted respiratory failure (odds ratio, 7.80; 95% confidence interval, 2.43-26.95; P < .001). Mortality rate at 28 days was 36%; ATN and hospital-...