The Effects of Chronic Treatment with Octreotide versus Octreotide plus Midodrine on Systemic Hemodynamics and Renal Hemodynamics and Function in Nonazotemic Cirrhotic Patients with Ascites

Kalambokis, Georgios; Economou, Michael; Fotopoulos, Andreas; Bokharhii, Jihad Al; Christos, Pappas; Katsaraki, Afroditi; Tsianos, Epameinondas V.

doi:10.1111/j.1572-0241.2005.40899.x

Cited by 79 publications

(75 citation statements)

References 42 publications

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“…Table 5 summarises all human data on the effects of somatostatin or octreotide on kidney function. Somatostatin and octreotide have been described in healthy subjects and patients with diabetes mellitus and acromegaly to decrease renal plasma flow (RPF) and concomitantly decrease glomerular filtration rate (GFR) with an unchanged filtration fraction [25][26][27][28][29][30][31][32]. However, it should be noted that some of these studies administered supraphysiological doses of somatostatin [100-420 μg/h intravenously (IV) or 600 μg/day subcutaneously (SC)].…”

Section: Discussionmentioning

confidence: 99%

Somatostatin receptor subtype 2-mediated uptake of radiolabelled somatostatin analogues in the human kidney

Rolleman

Kooij

Herder

et al. 2007

Eur J Nucl Med Mol Imaging

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Purpose Renal irradiation is a dose-limiting factor in peptide receptor radionuclide therapy using radiolabelled somatostatin analogues. This irradiation is mainly caused by reabsorption of radiolabelled peptides in the proximal tubule. In the human kidney, somatostatin receptors are expressed in the vasa recta, tubuli and glomeruli. It is not clear to what extent these receptors contribute to the total kidney radioactivity uptake. Methods Retrospectively, [ 111

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Section: Discussionmentioning

confidence: 99%

Somatostatin receptor subtype 2-mediated uptake of radiolabelled somatostatin analogues in the human kidney

Rolleman

Kooij

Herder

et al. 2007

Eur J Nucl Med Mol Imaging

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“…In type 1 HRS, alpha-1 agonists have only been used in combination with other agents. Few nonrandomized, prospective studies have evaluated treatment with both midodrine and octreotide [45][46][47] . The study by Angeli [45] included only fi ve patients and showed that after 20 d of treatment, all patients had serum creatinine levels below 2 mg/dL.…”

Section: Other Results Commentsmentioning

confidence: 99%

Hepatorenal syndrome

Turban¹

2007

WJG

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Hepatorenal syndrome (HRS) is a "functional" and reversible form of renal failure that occurs in patients with advanced chronic liver disease. The distinctive hallmark feature of HRS is the intense renal vasoconstriction c a u s e d b y i n t e ra c t i o n s b e t w e e n s y s t e m i c a n d portal hemodynamics. This results in activation of vasoconstrictors and suppression of vasodilators in the renal circulation. Epidemiology, pathophysiology, as well as current and emerging therapies of HRS are discussed in this review.

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“…Midodrine is an oral alpha adrenergic agonist and it is administered as an initial dose of 7.5 mg every eight hours (maximum 15g to eight hours) and octreotide could be administered as a continuous infusion with a dose of 50 mcg/hour or subcutaneous with a dose of 100-200 mcg/8 hours. In combination with midodrine and octreotide, albumin is given as an intravenous bolus with a starting dose of 1 g/kg (maximum 100 g) and a maintenance dose of 20-50 g. Midodrine in combination with octreotide and albumin improve systemic and renal hemodynamic status [28]. Norepinephrine is a general vasoconstrictor agent used in the intensive care unit and it is administered as an intravenous continuous infusion with a dose of 0.5-3 mg/hour.…”

Section: Hrs Treatmentmentioning

confidence: 99%

Hepatorenal Syndrome: Diagnosis and Treatment – newsreel –

Petrescu

Mitruţ

Petrescu

et al. 2016

Romanian Journal of Internal Medicine

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Hepatorenal syndrome (HRS) is defined as renal failure that occurs in the presence of severe acute or chronic liver disease in the absence of underlying renal pathology. Due to the functional nature of the disease and the absence of specific diagnostic markers, HRS diagnosis is determined based on positive criteria associated with excluding other causes of renal failure in patients with liver cirrhosis and ascites. Differentiation from other types of acute or chronic renal disease is extremely difficult and therapeutic options are limited, prophylactic behavior is most appropriate in patients with severe hepatic disease and risk factors for the installation of hepatorenal syndrome.Highlighting all precipitating factors of acute renal insufficiency and therapeutic modalities in order to minimize adverse events is an important step in improving the follow-up of the patients with liver cirrhosis. The prognosis is reserved especially for type 1 HRS. Liver transplantation is the best option for patients without contraindications. The therapies introduced in recent years, such as vasoconstrictor drugs or transjugular intrahepatic portosystemic shunt are effective methods in the renal function improvement.

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The Effects of Chronic Treatment with Octreotide versus Octreotide plus Midodrine on Systemic Hemodynamics and Renal Hemodynamics and Function in Nonazotemic Cirrhotic Patients with Ascites

Abstract: Octreotide does not improve systemic hemodynamics in nonazotemic cirrhotic patients with ascites while it impairs renal function. On the other hand, the addition of midodrine can ameliorate the hyperdynamic circulation without inducing renal dysfunction in these patients.

Cited by 79 publications

References 42 publications

Somatostatin receptor subtype 2-mediated uptake of radiolabelled somatostatin analogues in the human kidney

Somatostatin receptor subtype 2-mediated uptake of radiolabelled somatostatin analogues in the human kidney

Hepatorenal syndrome

Hepatorenal Syndrome: Diagnosis and Treatment – newsreel –

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