The effect of octapressin on renal and intrarenal blood flow in cirrhosis of the liver

Abstract

SUMMARY The effect of octapressin (2-phenylalanine-8-lysine vasopressin) on renal and intrarenal blood flow was studied in 11 normotensive cirrhotic patients with abnormal renal perfusion. Renal haemodynamic changes were assessed with the '33Xenon washout technique. Of the six patients given suppressor doses of octapressin intravenously renal blood flow improved in one only. A further three patients responded to the drug in a dose which increased the mean arterial pressure by 5 Ol more mm Hg. The increase in mean renal blood flow was accompanied by an improvement in renal cortical perfusion. In two patients renal blood flow decreased after the administration of octapressin. These findings, in conjunction with previous reports, suggest that octapressin will only consistently improve renal perfusion in cirrhotic subjects who are hypotensive and in whom the mean arterial blood pressure is raised by the drug, but do not exclude the possibility that octapressin may have a direct renal circulatory effect in some patients.

Diagnosis, prevention and treatment of hepatorenal syndrome in cirrhosis

“…44 More recently, Lenz et al 45 showed that GFR may be moderately improved by ornipressin infusion in patients with HRS, but the drug was given for only 4 h, therefore precluding assessment of its long-term effects. Two more studies demonstrated that a long-term (1-2 weeks) infusion of ornipressin, combined with albumin or dopamine, normalised serum creatinine concentrations in many patients with type-1 HRS.…”

EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis

“…The most effective method currently available is the administration of vasoconstrictor drugs. Among the vasoconstrictors used, those that have been investigated more extensively are the vasopressin analogues particularly terlipressin [195,[201][202][203][204][205][206][207][208][209]. The rationale for the use of vasopressin analogues in HRS is to improve the markedly impaired circulatory function by causing a vasoconstriction of the extremely dilated splanchnic vascular bed and increasing arterial pressure [210,211].…”

Vasoconstrictor Therapy for Hepatorenal Syndrome in Liver Cirrhosis

“…In a study in 1972 by Kew et al, low-dose octapressin (0.06 to 1.0 IU/h) significantly increased blood pressure in five of 11 cirrhotics with abnormal renal perfusion [50]. In three of those five patients, an increase in renal blood flow was observed.…”