Is misoprostol effective for the treatment of hepatorenal syndrome (HRS)?

Updated: Oct 16, 2017
  • Author: Deepika Devuni, MD; Chief Editor: BS Anand, MD  more...
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Answer

Misoprostol is a synthetic analogue of PG E1, whose use in HRS was based on the observation that these patients had low urinary levels of vasodilatory PGs.

Five studies have assessed the role of either parenteral or oral misoprostol in HRS. None of these studies demonstrated an improvement in the GFR, sodium excretion, or renal function in patients with HRS. Although Fevery et al demonstrated reversal of HRS in 4 patients, these patients also received large doses of colloids. [27] The likely scenario is that the massive administration of fluids played a predominant role here because Gines et al were unable to reproduce these findings with misoprostol alone. [28]


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