Research Information System
Turkish Journal of Gastroenterology, vol.36, no.3, pp.193-196, 2025 (SCI-Expanded, Scopus, TRDizin)
Hepatorenal syndrome with acute kidney injury (HRS- AKI) is a rapidly progressing, often fatal, but potentially reversible decline in renal function. It results from func- tional hemodynamic decreases in renal arterial perfusion in patients with decompensated cirrhosis. Liver trans- plantation is the definitive treatment for HRS-AKI. In the absence of liver transplantation, supportive treatment options include the administration of systemic vaso- constrictors, such as somatostatin analogs (octreotide), α-adrenergic agonists, midodrine, and norepinephrine, in conjunction with intravenous (IV) albumin. Terlipressin is a long-acting synthetic vasopressin analog that has been used for over 20 years in Europe for the management of acute bleeding esophageal varices and HRS-AKI, gener- ally presenting fewer complications and less severe side effects compared to vasopressin. The effectiveness of other vasoconstrictors has been studied in several stud- ies; some found them to be less effective than terlipres- sin, while others reported similar effectiveness. However, recent literature reports have indicated an increasing incidence of acute skin necrosis associated with terlip- ressin.1-3 In this case series, we describe 3 cases from our clinic over the past year where patients developed ische- mic skin necrosis while undergoing terlipressin treatment for HRS-AKI.