Terlipressin on Effect of Renal Function in Cirrhotic Patients With Acute Gastrointestinal Hemorrhage

Study Overview
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Brief Summary
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Terlipressin and somatostatin/octreotide are the first-line choices for the treatment of acute variceal bleeding in liver cirrhosis. Acute kidney injury can develop in patients presenting with acute variceal bleeding. On the other hand, evidence suggests that terlipressin can reverse hepatorenal syndrome. It has been hypothesized that terlipressin can protect the renal function in cirrhotic patients with acute variceal bleeding, except for control of bleeding.

Official Title
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Terlipressin Versus Somatostatin/Octreotide on Effect of Renal Function in Cirrhotic Patients With Acute Gastrointestinal Hemorrhage (TORCH): A Retrospective Multicenter Observational Study

Conditions
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Variceal Hemorrhage, Cirrhosis, Liver, Kidney Injury

Intervention / Treatment
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* Drug: Terlipressin
* Drug: Somatostatin
* Drug: Octreotide


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Cirrhotic patients who were admitted between January 2010 and December 2018. A diagnosis of acute gastrointestinal bleeding. Patients who received terlipressin or somatostatin/octreotide. Age or sex was not limited. Use of endoscopy was not limited. Comorbidity was not limited. Malignancy was not limited. Exclusion Criteria: Renal parenchymal diseases. Absence of baseline serum creatinine. Absence of serum creatinine 3-5 days after terlipressin or somatostatin/octreotide. Duration of terlipressin or somatostatin/octreotide was less 3 days. Patients who underwent transjugular intrahepatic portosystemic shunt. Patients who underwent surgical shunt, splenectomy with or without devascularization, or liver transplantation.
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Terlipressin group<br>Cirrhotic patients with acute gastrointestinal bleeding received terlipressin with or without somatostatin/octreotide. | Drug: Terlipressin<br>* Continuous or intermittent intravenous infusion of terlipressin was given.<br>* Other names: Glypressin;|
| Somatostatin/Octreotide group<br>Cirrhotic patients with acute gastrointestinal bleeding received somatostatin and/or octreotide without terlipressin. | Drug: Somatostatin<br>* Continuous or intermittent intravenous infusion of somatostatin was given.<br>* Other names: Stilamin;Drug: Octreotide<br>* Continuous or intermittent intravenous infusion of octreotide was given.<br>* Other names: Sandostatin;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of ICA-AKI and kidney function damage in cirrhotic patients with acute gastrointestinal bleeding | ICA-AKI and kidney function damage | Through study completion, an average of 1-2 weeks | 
| Effect of ICA-AKI and kidney function damage on in-hospital mortality of cirrhotic patients with acute gastrointestinal bleeding | In-hospital mortality | Through study completion, an average of 1-2 weeks | 
| Effect of terlipressin on the in-hospital mortality of cirrhotic patients with acute gastrointestinal bleeding with ICA-AKI and kidney function damage | In-hospital mortality associated with ICA-AKI and kidney function damage | Through study completion, an average of 1-2 weeks |