Abstract
Background and aims
Transjugular intrahepatic porto-systemic shunt (TIPS) ameliorates renal function in
type-2 hepatorenal syndrome (HRS). Available evidence is based on ‘old’ HRS diagnostic
criteria, and not on the current definition of HRS – chronic kidney disease (HRS-CKD).
Among patients who underwent TIPS for refractory ascites over the last 12 years, we
investigated clinical and renal function evolution of those with HRS-CKD.
Methods
among 212 patients, 41 with HRS-CKD were included. Renal function was evaluated for
12 months after TIPS, along with management of ascites and transplant-free survival
(TFS).
Results
renal function significantly improved already one week after TIPS [serum creatinine
(sCr): 1.37 ± 0.23 vs 1.94 ± 0.54 mg/dl, p< 0.001]; the amelioration was maintained during the whole follow-up and was observed
in every CKD stage, defined according to baseline estimated Glomerular Filtration
Rate (eGFR). sCr and eGFR became comparable between different CKD stages after only
one week, whilst significantly different at baseline. TIPS led to a remarkable improvement
in the control of ascites in all CKD stages and no significant differences in TFS
were recorded.
Conclusions
TIPS led to an early, substantial and persistent improvement in renal function in
patients with HRS-CKD, irrespective of their baseline CKD stage.
Keywords
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Article info
Publication history
Published online: October 05, 2021
Accepted:
September 14,
2021
Received:
April 10,
2021
Identification
Copyright
© 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
