Terlipressin Infusion Alone Vs Terlipressin With Noradrenaline Infusion In The Treatment of Hepatorenal Syndrome Type 1

Inclusion Criteria

• •1. age\>18 years and \<80 yrs;
• •2. Cirrhosis as diagnosed by clinical findings, endoscopy or USG examination or by liver biopsy.
• •3. HRS I as defined by the following features:
• •1. The patient should have Cirrhosis and also ascites
• •2. Renal failure of rapid onset -Initial value of sCr, doubling to reach a level of more than 226mmol/L (2.5 mg/dL) in less than two weeks
• •3. There should be absence of shock.
• •4. sCr value does not reduce to less than 1.5 mg/dl even after 2 days of stopping diuretics and giving Inj.Albumin for plasma volume expansion (1g/kg ) upto 100g/day.
• •5. No H/O being treated currently or recently with drugs having nephrotoxicity.
• •6. Absence of parenchymal renal disease:
• •* Proteinuria \< 0.5g/day
• •* Absence of microhaematuria (\<50 red cells/high powered field)
• •* Normal renal ultrasonography