Impact of long-term continuous terlipressin infusion on the renin-angiotensin-aldosterone system in patients with decompensated cirrhosis

Abstract

Background and aims Pooling of blood in the splanchnic circulation due to cirrhotic portal hypertension reduces effective circulating blood volume and activates the renin-angiotensinaldosterone system (RAAS). This study investigates the effects of long-term continuous terlipressin infusion (CTI) on the RAAS in patients with decompensated cirrhosis. Methods 30 participants with cirrhosis and ascites were enrolled in a prospective crossover study comparing 12weeks of home CTI to observation. Analysis of plasma renin concentration, aldosterone, ACE and ACE2 activity was performed. Results The median age of participants was 62 years (IQR 57–64), median model for end-stage liver disease-Na was 16..