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Hepatorenal syndrome (HRS) is a complication of cirrhosis and is associated with substantial morbidity and mortality. The systemic vasodilation seen in advanced cirrhosis leads to compensatory renal vasoconstriction, which in turn leads to HRS. No effective therapy is available. However, vasoconstrictors, such as vasopressin and terlipressin, might treat the syndrome by improving effective arterial blood volume. In this role, terlipressin is better tolerated and has fewer cardiovascular side effects than vasopressin does. Two companion studies, the first performed in Spain and the second in the U.S., have now evaluated the efficacy and safety of terlipressin in the treatment of HRS.
The first study was a randomized, controlled trial in 46 ci…