SynthesisPloS one2014
Terlipressin versus norepinephrine in the treatment of hepatorenal syndrome: a systematic review and meta-analysis.
Synthesis in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
45 citing papers in PubMed, 6 syntheses or guidelines pooled it, 128 citations in OpenAlex.
- Terlipressin versus placebo or noradrenalin in the treatment of hepatorenal syndrome: a systematic review and meta-analysis.Frontiers in pharmacology · 2024Pooled it
- Pooled it
- Treatment for hepatorenal syndrome in people with decompensated liver cirrhosis: a network meta-analysis.The Cochrane database of systematic reviews · 2019Pooled it
- KASL clinical practice guidelines for liver cirrhosis: Ascites and related complications.Clinical and molecular hepatology · 2018Guideline
- Terlipressin in the treatment of hepatorenal syndrome: A systematic review and meta-analysis.Medicine · 2018Pooled it
- Terlipressin versus other vasoactive drugs for hepatorenal syndrome.The Cochrane database of systematic reviews · 2017Pooled it
- Noradrenaline versus terlipressin in the management of type 1 hepatorenal syndrome: A randomized controlled study.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2018Trial
- KASL clinical practice guidelines for liver cirrhosis: Ascites and related complications 2026.Clinical and molecular hepatology · 2026Article
- The Physiology, Pathophysiology, and Clinical Implications of Fluid Resuscitation in Critically Ill Patients.Cureus · 2026Review
- Treating Hepatorenal Syndrome in the Current Era.Journal of the American Society of Nephrology : JASN · 2026Review
- Management of the acute on chronic liver failure in the intensive care unit.Liver international : official journal of the International Association for the Study of the Liver · 2025Review
- Advances in the diagnosis and management of hepatorenal syndrome: insights into HRS-AKI and liver transplantation.eGastroenterology · 2023Review
- Acute Kidney Injury in Liver Cirrhosis.Diagnostics (Basel, Switzerland) · 2023Review
- Review
- Recent advances in pathophysiology, diagnosis and management of hepatorenal syndrome: A review.World journal of hepatology · 2023Review
- Respiratory events with terlipressin and albumin in hepatorenal syndrome: A review and clinical guidance.Liver international : official journal of the International Association for the Study of the Liver · 2022Review
- Practice guidance for the use of terlipressin for liver cirrhosis-related complications.Therapeutic advances in gastroenterology · 2022Article
- Management of hepatorenal syndrome in liver cirrhosis: a recent update.Therapeutic advances in gastroenterology · 2022Review
- Feasibility and Effectiveness of Norepinephrine Outside the Intensive Care Setting for Treatment of Hepatorenal Syndrome.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2021Article
- Acute kidney injury in hospitalized cirrhotic patients: Risk factors, type of kidney injury, and survival.JGH open : an open access journal of gastroenterology and hepatology · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHepatorenal syndrome (HRS) is a severe and progressive functional renal failure occurring in patients with cirrhosis and ascites. Terlipressin is recognized as an effective treatment of HRS, but it is expensive and not widely available. Norepinephrine could be an effective alternative. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of norepinephrine compared to terlipressin in the management of HRS.
methodsWe searched the Medline, Embase, Scopus, CENTRAL, Lilacs and Scielo databases for randomized trials of norepinephrine and terlipressin in the treatment of HRS up to January 2014. Two reviewers collected data and assessed the outcomes and risk of bias. The primary outcome was the reversal of HRS. Secondary outcomes were mortality, recurrence of HRS and adverse events.
resultsFour studies comprising 154 patients were included. All trials were considered to be at overall high risk of bias. There was no difference in the reversal of HRS (RR = 0.97, 95% CI = 0.76 to 1.23), mortality at 30 days (RR = 0.89, 95% CI = 0.68 to 1.17) and recurrence of HRS (RR = 0.72; 95% CI = 0.36 to 1.45) between norepinephrine and terlipressin. Adverse events were less common with norepinephrine (RR = 0.36, 95% CI = 0.15 to 0.83).
conclusionsNorepinephrine seems to be an attractive alternative to terlipressin in the treatment of HRS and is associated with less adverse events. However, these findings are based on data extracted from only four small studies.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.