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2026, Vol: 10, Issue: 7
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Review Article 


Terlipressin versus norepinephrine in the treatment of type 1 hepatorenal syndrome: a review

Ibrahim Mahmoud H. Ajwah, Wejdan Hlel Al-atawi, Raghad Fraih A. Al-balawi, Maram Atallah M. Albalawi, Abdulaziz Saed A. Albalawi, Rola Ali S. Alotabi, Sarah Fahad M. Bukhari, Amal Sulaiman A. Al-balawi, Abdulaziz Saeed Alghamdi, Nouf Obaidullah M. Alenazi, Lama Akram A. Alanazi, Reham Hamid Alruhil, Faisal Shiraz M. Alharthi, Sarah Muqbil B. Altmimi, Shahad Suliman H. Aljuhani, Raghad Saud A. Albalawi.


Abstract
Hepatorenal syndrome (HRS) is a potentially reversible clinical syndrome in which a functional renal failure occurs in end-stage liver disease cases. It is a fatal complication of advanced cirrhosis with ascites and liver failure, with nearly 50% of the patients dying within 2 weeks after the onset. While terlipressin is expensive and not widely available, it is recognized as an effective treatment for HRS. Noradrenaline could be an efficient substitute. This is a systematic review that was carried out, including PubMed, Google Scholar, and EBSCO databases, which examined randomized trials of norepinephrine and terlipressin in the treatment of HRS to summarize the major RCTs that compare terlipressin versus norepinephrine in the treatment of type 1 HRS (HRS-). This review included six randomized studies that compared norepinephrine and terlipressin in the treatment of HRS-1. The findings show that two treatments had the same HRS reversal rate and the difference in efficacy in treating HRS-1. This review concludes that there is no difference in the efficacy of norepinephrine and terlipressin in the treatment of HRS-1. Norepinephrine is found to be effective and as safe as terlipressin. It is less expensive, widely available in many countries, and could be used as an alternative to terlipressin in the management of HRS-1.

Key words: Terlipressin, hepatorenal, liver


 
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How to Cite this Article
Pubmed Style

Ajwah IMH, Al-atawi WH, Al-balawi RFA, Albalawi MAM, Albalawi ASA, Alotabi RAS, Bukhari SFM, Al-balawi ASA, Alghamdi AS, Alenazi NOM, Alanazi LAA, Alruhil RH, Alharthi FSM, Altmimi SMB, Aljuhani SSH, Albalawi RSA. Terlipressin versus norepinephrine in the treatment of type 1 hepatorenal syndrome: a review. IJMDC. 2020; 4(12): 2351-2356. doi:10.24911/IJMDC.1-1602771830

Web Style

Ajwah IMH, Al-atawi WH, Al-balawi RFA, Albalawi MAM, Albalawi ASA, Alotabi RAS, Bukhari SFM, Al-balawi ASA, Alghamdi AS, Alenazi NOM, Alanazi LAA, Alruhil RH, Alharthi FSM, Altmimi SMB, Aljuhani SSH, Albalawi RSA. Terlipressin versus norepinephrine in the treatment of type 1 hepatorenal syndrome: a review. https://www.ijmdc.com/?mno=14192 [Access: June 27, 2026]. doi:10.24911/IJMDC.1-1602771830

AMA (American Medical Association) Style

Ajwah IMH, Al-atawi WH, Al-balawi RFA, Albalawi MAM, Albalawi ASA, Alotabi RAS, Bukhari SFM, Al-balawi ASA, Alghamdi AS, Alenazi NOM, Alanazi LAA, Alruhil RH, Alharthi FSM, Altmimi SMB, Aljuhani SSH, Albalawi RSA. Terlipressin versus norepinephrine in the treatment of type 1 hepatorenal syndrome: a review. IJMDC. 2020; 4(12): 2351-2356. doi:10.24911/IJMDC.1-1602771830


Vancouver/ICMJE Style

Ajwah IMH, Al-atawi WH, Al-balawi RFA, Albalawi MAM, Albalawi ASA, Alotabi RAS, Bukhari SFM, Al-balawi ASA, Alghamdi AS, Alenazi NOM, Alanazi LAA, Alruhil RH, Alharthi FSM, Altmimi SMB, Aljuhani SSH, Albalawi RSA. Terlipressin versus norepinephrine in the treatment of type 1 hepatorenal syndrome: a review. IJMDC. (2020), [cited June 27, 2026]; 4(12): 2351-2356. doi:10.24911/IJMDC.1-1602771830


Harvard Style

Ajwah, I. M. H., Al-atawi, . W. H., Al-balawi, . R. F. A., Albalawi, . M. A. M., Albalawi, . A. S. A., Alotabi, . R. A. S., Bukhari, . S. F. M., Al-balawi, . A. S. A., Alghamdi, . A. S., Alenazi, . N. O. M., Alanazi, . L. A. A., Alruhil, . R. H., Alharthi, . F. S. M., Altmimi, . S. M. B., Aljuhani, . S. S. H. & Albalawi, . R. S. A. (2020) Terlipressin versus norepinephrine in the treatment of type 1 hepatorenal syndrome: a review. IJMDC, 4 (12), 2351-2356. doi:10.24911/IJMDC.1-1602771830


Turabian Style

Ajwah, Ibrahim Mahmoud H., Wejdan Hlel Al-atawi, Raghad Fraih A. Al-balawi, Maram Atallah M. Albalawi, Abdulaziz Saed A. Albalawi, Rola Ali S. Alotabi, Sarah Fahad M. Bukhari, Amal Sulaiman A. Al-balawi, Abdulaziz Saeed Alghamdi, Nouf Obaidullah M. Alenazi, Lama Akram A. Alanazi, Reham Hamid Alruhil, Faisal Shiraz M. Alharthi, Sarah Muqbil B. Altmimi, Shahad Suliman H. Aljuhani, and Raghad Saud A. Albalawi. 2020. Terlipressin versus norepinephrine in the treatment of type 1 hepatorenal syndrome: a review. International Journal of Medicine in Developing Countries, 4 (12), 2351-2356. doi:10.24911/IJMDC.1-1602771830


Chicago Style

Ajwah, Ibrahim Mahmoud H., Wejdan Hlel Al-atawi, Raghad Fraih A. Al-balawi, Maram Atallah M. Albalawi, Abdulaziz Saed A. Albalawi, Rola Ali S. Alotabi, Sarah Fahad M. Bukhari, Amal Sulaiman A. Al-balawi, Abdulaziz Saeed Alghamdi, Nouf Obaidullah M. Alenazi, Lama Akram A. Alanazi, Reham Hamid Alruhil, Faisal Shiraz M. Alharthi, Sarah Muqbil B. Altmimi, Shahad Suliman H. Aljuhani, and Raghad Saud A. Albalawi. "Terlipressin versus norepinephrine in the treatment of type 1 hepatorenal syndrome: a review." International Journal of Medicine in Developing Countries 4 (2020), 2351-2356. doi:10.24911/IJMDC.1-1602771830


MLA (The Modern Language Association) Style

Ajwah, Ibrahim Mahmoud H., Wejdan Hlel Al-atawi, Raghad Fraih A. Al-balawi, Maram Atallah M. Albalawi, Abdulaziz Saed A. Albalawi, Rola Ali S. Alotabi, Sarah Fahad M. Bukhari, Amal Sulaiman A. Al-balawi, Abdulaziz Saeed Alghamdi, Nouf Obaidullah M. Alenazi, Lama Akram A. Alanazi, Reham Hamid Alruhil, Faisal Shiraz M. Alharthi, Sarah Muqbil B. Altmimi, Shahad Suliman H. Aljuhani, and Raghad Saud A. Albalawi. "Terlipressin versus norepinephrine in the treatment of type 1 hepatorenal syndrome: a review." International Journal of Medicine in Developing Countries 4.12 (2020), 2351-2356. Print. doi:10.24911/IJMDC.1-1602771830


APA (American Psychological Association) Style

Ajwah, I. M. H., Al-atawi, . W. H., Al-balawi, . R. F. A., Albalawi, . M. A. M., Albalawi, . A. S. A., Alotabi, . R. A. S., Bukhari, . S. F. M., Al-balawi, . A. S. A., Alghamdi, . A. S., Alenazi, . N. O. M., Alanazi, . L. A. A., Alruhil, . R. H., Alharthi, . F. S. M., Altmimi, . S. M. B., Aljuhani, . S. S. H. & Albalawi, . R. S. A. (2020) Terlipressin versus norepinephrine in the treatment of type 1 hepatorenal syndrome: a review. International Journal of Medicine in Developing Countries, 4 (12), 2351-2356. doi:10.24911/IJMDC.1-1602771830




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