TERLIPRESSIN THERAPY RESPONSE ASSESSED BY COLOUR DOPPLER IMAGING IN PATIENTS OF HEPATORENAL SYNDROME
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 75
Abstract
BACKGROUND The resistive index of renal arteries is the most widely used parameter to estimate the arteriolar vascular resistance in HRS. We aimed to evaluate the effects of terlipressin on renal haemodynamics using resistive index of renal interlobar arteries in such patients. MATERIALS AND METHODS An interventional randomised controlled clinical trial was planned with two groups, namely study group and control group. The study enrolled 40 cases of hepatorenal syndrome. These 40 cases were randomly allocated using computer generated random allocation sequence into two groups of size 20 each. The twenty patients of study group received terlipressin therapy, and other twenty comprised the control group. All underwent upper GI endoscopy and Colour Doppler examination. Terlipressin 1 mg 6 hourly intravenously was administered to patients in the study group for 2 days after which Doppler studies were repeated to evaluate the effect of terlipressin on resistive index. Statistical Analysis- Statistical analysis included paired t test for intragroup comparison and unpaired t test for intergroup comparison. A ‘p’ value of <0.05 was considered statistically significant. Settings and Design- The present study was carried out in Department of Medicine, Department of Radiology Department of Gastroenterology, SS Hospital, BHU Varanasi. A total of 40 cases of clinically suspected and diagnosed cases of hepatorenal syndrome on the basis of criteria defined by International Ascites Club Consensus Workshop in 2007 were taken, among them 20 patients in which terlipressin was used comprised the study group and 20 patients in which terlipressin was not used comprised the control group. Informed consent had been obtained from patients. RESULTS On examination, ascites was detected in all patients in both study and control groups. Majority of chronic liver diseases leading to HRS were related to alcohol followed by hepatitis B in both groups. There was significant reduction in mean resistive indices in interlobar arteries indicating beneficial effect of terlipressin on renal haemodynamics. There was significant decrease in resistive index of interlobar renal arteries in study group as compared to control group, after terlipressin therapy. CONCLUSION This study is first of its kind to utilise colour flow imaging for objective assessment of renal haemodynamics using resistive index as a parameter and study the favourable effect of Terlipressin in patients of hepatorenal syndrome.
Authors and Affiliations
Amit Nandan Dhar Dwivedi, Asif Iqbal, Ram Chandra Shukla, Vinod Kumar Dixit, Srishti Sharma, Vairavaganesh R. A
Keywords
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- EP ID EP266954
- DOI 10.14260/Jemds/2017/1163
- Views 92
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