Effects of terlipressin on perioperative renal protection inpatients with liver cirrhosis and portal hypertension

doi:10.3969/j.issn.1006-7795.2018.05.022

Abstract

Abstract: Objective To explore the effects of terlipressin on perioperative renal protection in patients with liver cirrhosis and portal hypertension splenectomy. Methods Forty-two American Society of Anesthesiologists (ASA) Ⅱor Ⅲ patients(28 male,14 female) aged 18-65 Year weighing 44-85 kg were randomly divided into 2 groups (n=21 each):terlipressin group and control group.In terlipressin group 2 mg of terlipressin was added to 50 mL of normal saline (NS) and was continuously infused at 10 mL/h from beginning of operation until the end of the operation,while in control group NS was infused instead of terlipressin. Three days after the incidence of acute kidney injury(AKI) and renal index. Blood and urine samples were taken before operation(T1 baseline),after operation(T2) and on the first and third day after operation(T3,T4) for determination of urinary N-acetyl-β-D-glucosidase (NAG), β2-microglobulin(β2-MG), microalbuminuria(Malb),α1-microglobulin(α1-MG),blood urea nitrogen(BUN), serum creatinine (SCr), blood β2-MG and serum cystatin C(CysC) concentration, glomerular filtration rate (GFR), urine,diuretic use in the urine.Results Two groups of patients did not occur AKI after the operation. Various renal function indicators has no statistically significant difference in the group except the diuretics were significantly lower at T2 in terlipressin group than in control group(P<0.05).But there were still some differences between the two groups when comparison was respectively made inside the groups.The GFR in the experimental group T4 was significantly increased than that of T1, while the control group have no significantly difference (P<0.01).Postoperative renal function indexes between groups, the urine β2-MG were significantly increased at T2 and T3 as compared with the baseline at T1 in control group(P<0.01),but there was no statistical difference in the experimental group. Conclusion Intravenous infusion of terlipressin may have the potential to improve the postoperative GFR in patients with liver cirrhosis and portal hypertension splenectomy, but the results still can not determine the protective effect of renal function perioperatively.

Key words: terlipressin, splenectomy, kidney function tests, cirrhosis, hepatorenal syndrome

CLC Number:

R657.3⁺1

Ding Qiao, Yue Yun, Cheng Hao. Effects of terlipressin on perioperative renal protection inpatients with liver cirrhosis and portal hypertension[J]. Journal of Capital Medical University, 2018, 39(5): 741-746.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2018.05.022

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2018/V39/I5/741

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