Hepatorenal Syndrome에 대한 Prostaglandin E1 유사화합물인 Misoprostol의 치료 효과 = The Effects of Prostaglandin E1 Analogue(Misoprostol) in Patients with Hepatorenal SyndromeHepatorenal Syndrome에 대한 Prostaglandin E1 유사화합물인 Misoprostol의 치료 효과

다국어 초록 (Multilingual Abstract)

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다국어 초록 (Multilingual Abstract)

Hepatorenal syndrome is a functional renal impairrnent occuring mainly, but not exclusive- ly, in decompensated cirrhosis. Its pronosis is very poor. We studied to evaluate the effect of misoprostol (prostaglandin E, analogue) in patients with hepatorenal syndrome. We observed the therapeutic effect of oral misoprostol(0.4mg, four times per day) for 12 days in six pa- t.ients with hepatorenal syndrome who had oliguria and renal functional deterioration despite adequate supp)ement of fluid. The mean urinary output obtained over the 4 days preceding misoprostol administration was 263, 328, 275, 232, 265 and 356 ml per 24 hours, respectively, in the six patients, despite adequate volume expansion by plasma albumin and fresh frozen plasma. Diuresis increased t,o 906, 900, 625, 1085, 1495 and 1038 ml per 24hours, respectively, on day 1 12 after onset of therapy. In addition of diuresis, serum creatinine levels were 3.5, 2.6, 2.7, 4.5, 4.2 and 3.6mg/ dl before and changed to 2.0,1.9, 2.2, 5.0, 2.1 and 2.9mg/dl during treatment. Therefore, recov- ery of renal function in five patients were evident. Spot urine sodium concentration increased from average 30mEq/L to 40mEq/L in six cases before and during the treatment of misoprostol. In the present study, the oral administration of high dose of misoprostol in patients with hepatorenal syndrome seems to produce marked diuresis with recovery of renal failure, sug gesting again the role of prostaglandin in the pathogenesis of hepatorenal syndrome. There- fore, until further improvements in the management of hepatorenal syndrome in the future, administration of synthetic prostaglandin E,(misoprostol) may constitute an acceptable thera peutic intervention.(Korean J Gastroenterol 1994; 26: 498 505)