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Contrast-enhanced ultrasound evaluation of the renal microcirculation response to terlipressin in hepato-renal syndrome: a preliminary report.
- Source :
- Renal Failure; Feb2015, Vol. 37 Issue 1, p175-179, 5p
- Publication Year :
- 2015
-
Abstract
- Background: Terlipressin improves renal function in some patients with type-1 hepato-renal syndrome (HRS). Renal contrast-enhanced ultrasound (CEUS), a novel imaging modality, may help to predict terlipressin responsiveness. Objectives: We used CEUS to estimate the effect of terlipressin on the renal cortical microcirculation in type-1 HRS. Methods: We performed renal CEUS scans with destruction-replenishment sequences using Sonovue® (Bracco, Milano Italy) as a contrast agent at baseline and after the intravenous administration of 1 mg of terlipressin, in four patients with type-1 HRS. We analyzed video sequences offline using dedicated software. We derived a perfusion index (PI) at each time point for each patient. Results: Patients 1 and 2 had severe presentation and were admitted to the intensive care unit. Both showed a marked increase in PI (+216% and + 567% of baseline) in response to terlipressin. Patients 3 and 4 had less severe presentations and had a decrease in PI (−53% and −20% of baseline) in response to terlipressin. Patients 1, 2, and 4, but not patient 3, responded to terlipressin therapy with a decrease in serum creatinine to <150 µmol/L. Conclusions: CEUS detected changes in renal cortical microcirculation in response to terlipressin and demonstrated heterogeneous microvascular responses to terlipressin. These initial proof-of-concept findings justify future investigations. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 0886022X
- Volume :
- 37
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- Renal Failure
- Publication Type :
- Academic Journal
- Accession number :
- 100066247
- Full Text :
- https://doi.org/10.3109/0886022X.2014.977140