SHM Converge Scientific Abstract ePoster Gallery-Real-World Utilization Patterns and Outcomes in Hospitalized U.S. Adults With Hepatorenal Syndrome-Acute Kidney Injury Treated With Terlipressin: A Retrospective Cohort Study

Real-World Utilization Patterns and Outcomes in Hospitalized U.S. Adults With Hepatorenal Syndrome-Acute Kidney Injury Treated With Terlipressin: A Retrospective Cohort Study

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This retrospective cohort study examined real-world use of terlipressin in hospitalized U.S. adults with hepatorenal syndrome–acute kidney injury (HRS-AKI) using the Premier Healthcare Database from September 2022 to May 2025. The study included 321 patients treated with terlipressin for at least 2 days.<br /><br />Patients had a median age of 57 years, were mostly male (64.5%), and were commonly White (67%). Alcohol-associated liver disease was the most frequent underlying cause of cirrhosis. Only 14.9% had pre-treatment serum creatinine (SCr) data available, with a median baseline SCr of 2.5 mg/dL.<br /><br />Terlipressin was used as first-line therapy in only about 25% of cases. It was often started late in the hospital course, with a median initiation on day 5; more than half of patients began treatment on day 5 or later. Prior to terlipressin, many patients received other HRS therapies such as midodrine and/or octreotide, and 25.2% required renal replacement therapy.<br /><br />Among the small subgroup with both pre- and post-treatment creatinine measurements (n=48), the median SCr decreased from 2.5 mg/dL to 1.6 mg/dL after treatment. About 42% achieved a renal response, and response appeared better when terlipressin was started at lower baseline SCr levels. During hospitalization, 41.4% required ICU care and median length of stay was 15 days.<br /><br />Nearly half of all patients were discharged home or with home health support, while in-hospital mortality was also reported among discharge outcomes.<br /><br />Overall, the study suggests terlipressin is frequently initiated late in real-world practice for HRS-AKI. Earlier recognition and treatment may improve renal outcomes.

Asset Subtitle

Xingyue Huang

Meta Tag

Author List A. Sidney Barritt IV, Christopher White, Jonathan Lilley, Kavish Patidar, Mary P. Panaccio, Nisha Wadhwani, Rachel Campbell Black, Rahul Rajkumar, Robert J. Wong, Xingyue Huang

Category Research

Concept Terlipressin

Concept Hepatorenal Syndrome-Acute Kidney Injury

Concept Creatinine

Concept Hospitalized Adults

Concept Inpatient Mortality

Distinguished Non-Finalist

Presenter Organization Keenova Therapeutics

Presenting Author Xingyue Huang

Track Outcomes Research

Keywords

terlipressin

hepatorenal syndrome

acute kidney injury

HRS-AKI

retrospective cohort

real-world study

cirrhosis

serum creatinine

renal response

hospitalized patients

Terlipressin

Hepatorenal Syndrome-Acute Kidney Injury

Creatinine

Hospitalized Adults

Inpatient Mortality