Efficacy and Predictors to Response of Octreotide and Midodrine Combination in Patients with Hepatorenal Syndrome

Abstract

Background: Hepatorenal syndrome (HRS) is a functional form of acute kidney injury (AKI) that develops in patients with advanced liver disease. The use of octreotide (OCT) and midodrine (MID) along with albumin is commonly used in practice despite lack of strong evidence. Objective: The purpose of the study is to evaluate the efficacy of combining octreotide and midodrine in HRS patients. Materials and Methods: This is a retrospective, single center study. All patients who received both OCT/MID from January 2005 to April 2013 were identified from the electronic pharmacy system at a major tertiary care center in Riyadh, Saudi Arabia. The aim of the study is to evaluate the safety and efficacy and predictors to response of the combination of OCT/MID in patients with decompensated liver cirrhosis with type I HRS receiving standard of care therapy. The primary endpoint was the change in estimated glomerular filtration rate (eGFR) within 30 days of starting therapy compared to baseline. Results: There was no significant improvement in eGFR using Cockcroft-Gault (CG) from baseline until the end of treatment (P = 0.311). Conclusion: Combination therapy of octreotide and midodrine along with albumin did not improve the eGFR in patients with type 1 HRS.