Noradrenalin Versus the Combination of Midodrine and Octreotide in Patients with Hepatorenal Syndrome: Randomized Clinical Trial

Background: hepatorenal syndrome (hrs) is known asdevelopment of acute renal failure in a patient who usually hasadvanced liver disease. the aim of the present study was todetermine the safety and the efficacy of noradrenalin in comparisonwith midodrine?octreotide in patients with hrs.methods: this study was registered to the iranian registry ofclinical trials (irct). this study was a single?center, randomized,clinical trial that performed in alzahra hospital, isfahan, iran.since march 2011 to january 2012, twenty?three patients wereenrolled in the study. eligible patients were allocated in 2 groups.in the first group, patients received infusion of na with thedose of 0.1–0.7 ?g/kg/min, and in the other groups, patientsreceived octreotide 100?200 ?g subcutaneously 3 times daily andmidodrine 5?15 mg orally 3 times daily. in both study groups,patient received albumin infusion in addition to noradrenalin ormidodrine?octreotide.results: complete response of hrs was observed in 8 of the11 patients (73%) treated with noradrenalin and in 9 of the12 patients (75%) treated with midodrine?octreotide (p > 0.05).hrs recurred after treatment withdrawal in 2 of 11 in na and 3of 12 in mo group. that shows no significant difference between2 groups (p > 0.05).conclusion: we deduce that na has the same efficacy and safetywith mo and can induce a complete response in high percentageof the patients. moreover, we observed no significant differencesin the recurrence rate and outcomes after 3 months among thepatients in both study groups; this result could support the use ofna in hrs management. the irct id is: irct201107217085n1.