Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pharmacol Ther. Aug 6, 2015; 6(3): 28-31
Published online Aug 6, 2015. doi: 10.4292/wjgpt.v6.i3.28
Current position of vasoconstrictor and albumin infusion for type 1 hepatorenal syndrome
Abhasnee Sobhonslidsuk
Abhasnee Sobhonslidsuk, Division of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
Author contributions: Sobhonslidsuk A solely contributed to this paper.
Conflict-of-interest statement: Abhasnee Sobhonslidsuk hereby denied any conflict of interest with regard to the present paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Abhasnee Sobhonslidsuk, MD, Associate Professor, Division of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama 6 road, Rajathevee, Bangkok 10400, Thailand. abhasnee.sob@mahidol.ac.th
Telephone: +66-02-2011304 Fax: +66-02-2011304
Received: March 30, 2015
Peer-review started: March 31, 2015
First decision: June 3, 2015
Revised: June 11, 2015
Accepted: July 21, 2015
Article in press: July 23, 2015
Published online: August 6, 2015
Core Tip

Core tip: Type 1 hepatorenal syndrome (HRS), which presents as acute kidney injury, is an uncommon, but critical problem in decompensated cirrhosis. The most common precipitating factor is infection especially spontaneous bacterial peritonitis. The combined regimen of albumin and vasoconstrictor is the pharmacotherapy of choice for type 1 HRS based on pathogenic mechanisms of peripheral and splanchnic vasodilatation. Prompt treatment with the combined regimen can lead to HRS reversal in 34%-60% of patients. Type 1 HRS can be prevented in cirrhotic complications such as albumin infusion for spontaneous bacterial peritonitis, large volume paracentesis with albumin replacement, and prophylactic antibiotics for upper gastrointestinal hemorrhage.