1,719
Views
0
CrossRef citations to date
0
Altmetric
Disorders Management

Association of non-selective β blockers with the development of renal dysfunction in liver cirrhosis: a systematic review and meta-analysis

, , , , &
Article: 2305935 | Received 03 Apr 2023, Accepted 09 Jan 2024, Published online: 25 Jan 2024

References

  • Garcia-Tsao G, Abraldes JG, Berzigotti A, et al. Portal hypertensive bleeding in cirrhosis: risk stratification, diagnosis, and management: 2016 practice guidance by the American association for the study of liver diseases. Hepatology. 2017;65(1):1–10. doi: 10.1002/hep.28906.
  • EASL clinical practice guidelines for the management of patients with decompensated cirrhosis. J Hepatol. 2018;69(2):406–460.
  • de Franchis R, Bosch J, Garcia-Tsao G, et al. Baveno VII - renewing consensus in portal hypertension. J Hepatol. 2022;76(4):959–974. doi: 10.1016/j.jhep.2021.12.022.
  • Villanueva C, Albillos A, Genescà J, et al. β blockers to prevent decompensation of cirrhosis in patients with clinically significant portal hypertension (PREDESCI): a randomised, double-blind, placebo-controlled, multicentre trial. Lancet. 2019;393(10181):1597–1608. doi: 10.1016/S0140-6736(18)31875-0.
  • Sasso R, Rockey DC. Non-selective beta-blocker use in cirrhotic patients is associated with a reduced likelihood of hospitalisation for infection. Aliment Pharmacol Ther. 2021;53(3):418–425. doi: 10.1111/apt.16156.
  • Krag A, Wiest R, Albillos A, et al. The window hypothesis: haemodynamic and non-haemodynamic effects of β-blockers improve survival of patients with cirrhosis during a window in the disease. Gut. 2012;61(7):967–969. doi: 10.1136/gutjnl-2011-301348.
  • Xu X, Guo X, De Stefano V, et al. Nonselective beta-blockers and development of portal vein thrombosis in liver cirrhosis: a systematic review and meta-analysis. Hepatol Int. 2019;13(4):468–481. doi: 10.1007/s12072-019-09951-6.
  • Turon F, Driever EG, Baiges A, et al. Predicting portal thrombosis in cirrhosis: a prospective study of clinical, ultrasonographic and hemostatic factors. J Hepatol. 2021;75(6):1367–1376. doi: 10.1016/j.jhep.2021.07.020.
  • Zang H, Liu F, Liu H, et al. Incidence, risk factors and outcomes of acute kidney injury (AKI) in patients with acute-on-chronic liver failure (ACLF) of underlying cirrhosis. Hepatol Int. 2016;10(5):807–818. doi: 10.1007/s12072-016-9756-z.
  • Garcia-Tsao G, Parikh CR, Viola A. Acute kidney injury in cirrhosis. Hepatology. 2008;48(6):2064–2077. doi: 10.1002/hep.22605.
  • Nadim MK, Garcia-Tsao G. Acute kidney injury in patients with cirrhosis. N Engl J Med. 2023;388(8):733–745. doi: 10.1056/NEJMra2215289.
  • Tsien CD, Rabie R, Wong F. Acute kidney injury in decompensated cirrhosis. Gut. 2013;62(1):131–137. doi: 10.1136/gutjnl-2011-301255.
  • Campbell MS, Kotlyar DS, Brensinger CM, et al. Renal function after orthotopic liver transplantation is predicted by duration of pretransplantation creatinine elevation. Liver Transpl. 2005;11(9):1048–1055. doi: 10.1002/lt.20445.
  • Tariq R, Hadi Y, Chahal K, et al. Incidence, mortality and predictors of acute kidney injury in patients with cirrhosis: a systematic review and meta-analysis. J Clin Transl Hepatol. 2020;8(2):135–142. doi: 10.14218/JCTH.2019.00060.
  • Tariq R, Singal AK. Management of hepatorenal syndrome: a review. J Clin Transl Hepatol. 2020;8(2):192–199. doi: 10.14218/JCTH.2020.00011.
  • Krag A, Bendtsen F, Burroughs AK, et al. The cardiorenal link in advanced cirrhosis. Med Hypotheses. 2012;79(1):53–55. doi: 10.1016/j.mehy.2012.03.032.
  • Krag A, Bendtsen F, Henriksen JH, et al. Low cardiac output predicts development of hepatorenal syndrome and survival in patients with cirrhosis and ascites. Gut. 2010;59(1):105–110. doi: 10.1136/gut.2009.180570.
  • Ruiz-del-Arbol L, Monescillo A, Arocena C, et al. Circulatory function and hepatorenal syndrome in cirrhosis. Hepatology. 2005;42(2):439–447. doi: 10.1002/hep.20766.
  • Ruiz-del-Arbol L, Urman J, Fernández J, et al. Systemic, renal, and hepatic hemodynamic derangement in cirrhotic patients with spontaneous bacterial peritonitis. Hepatology. 2003;38(5):1210–1218. doi: 10.1053/jhep.2003.50447.
  • Wells GA, Shea B, O’Connell D, et al. The Newcastle-Ottawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp.
  • Higgins JP, Altman DG, Gøtzsche PC, et al. The cochrane collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011;343(oct18 2):d5928–d5928. doi: 10.1136/bmj.d5928.
  • Borenstein M, Hedges LV, Higgins JP, et al. A basic introduction to fixed-effect and random-effects models for meta-analysis. Res Synth Methods. 2010;1(2):97–111. doi: 10.1002/jrsm.12.
  • Higgins JP, White IR, Anzures-Cabrera J. Meta-analysis of skewed data: combining results reported on log-transformed or raw scales. Stat Med. 2008;27(29):6072–6092. doi: 10.1002/sim.3427.
  • Balshem H, Helfand M, Schünemann HJ, et al. GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol. 2011;64(4):401–406. doi: 10.1016/j.jclinepi.2010.07.015.
  • Sersté T, Melot C, Francoz C, et al. Deleterious effects of beta-blockers on survival in patients with cirrhosis and refractory ascites. Hepatology. 2010;52(3):1017–1022. doi: 10.1002/hep.23775.
  • Kalambokis GN, Baltayiannis G, Christou L, et al. Red signs and not severity of cirrhosis should determine non-selective β-blocker treatment in child-pugh C cirrhosis with small varices: increased risk of hepatorenal syndrome and death beyond 6 months of propranolol use. Gut. 2016;65(7):1228–1230. doi: 10.1136/gutjnl-2016-311527.
  • Mandorfer M, Bota S, Schwabl P, et al. Nonselective β blockers increase risk for hepatorenal syndrome and death in patients with cirrhosis and spontaneous bacterial peritonitis. Gastroenterology. 2014;146(7):1680–1690.e1681. doi: 10.1053/j.gastro.2014.03.005.
  • Kimer N, Feineis M, Møller S, et al. Beta-blockers in cirrhosis and refractory ascites: a retrospective cohort study and review of the literature. Scand J Gastroenterol. 2015;50(2):129–137. doi: 10.3109/00365521.2014.948053.
  • Sersté T, Njimi H, Degré D, et al. The use of beta-blockers is associated with the occurrence of acute kidney injury in severe alcoholic hepatitis. Liver Int. 2015;35(8):1974–1982. doi: 10.1111/liv.12786.
  • Bang UC, Benfield T, Hyldstrup L, et al. Effect of propranolol on survival in patients with decompensated cirrhosis: a nationwide study based Danish patient registers. Liver Int. 2016;36(9):1304–1312. doi: 10.1111/liv.13119.
  • Kim SG, Larson JJ, Lee JS, et al. Beneficial and harmful effects of nonselective beta blockade on acute kidney injury in liver transplant candidates. Liver Transpl. 2017;23(6):733–740. doi: 10.1002/lt.24744.
  • Scheiner B, Parada-Rodriguez D, Bucsics T, et al. Non-selective beta-blocker treatment does not impact on kidney function in cirrhotic patients with varices. Scand J Gastroenterol. 2017;52(9):1008–1015. doi: 10.1080/00365521.2017.1329456.
  • Ngwa T, Orman E, Gomez EV, et al. Non-selective beta blocker use is associated with improved short-term survival in patients with cirrhosis referred for liver transplantation. BMC Gastroenterol. 2020;20(1):4. doi: 10.1186/s12876-019-1155-1.
  • Yoo JJ, Kim SG, Kim YS, et al. Propranolol plus endoscopic ligation for variceal bleeding in patients with significant ascites: propensity score matching analysis. Medicine. 2020;99(5):e18913.). doi: 10.1097/MD.0000000000018913.
  • Li TH, Liu CW, Huang CC, et al. Non-selective beta-blockers decrease infection, acute kidney injury episodes, and ameliorate sarcopenic changes in patients with cirrhosis: a propensity-score matching tertiary-center cohort study. J Clin Med. 2021;10(11):2244. doi: 10.3390/jcm10112244
  • Maiwall R, Pasupuleti SSR, Jain P, et al. Degree of portal and systemic hemodynamic alterations predict recurrent AKI and chronic kidney disease in patients with cirrhosis. Hepatol Commun. 2021;5(2):293–308. doi: 10.1002/hep4.1607.
  • Korobka VL, Pasetchnikov VD, Korobka RV, et al. Use of endoscopic band ligation alone and in combination with nonselective beta blockers for prevention of variceal bleeding in ascites patients on the liver transplant waiting list. RJTAO. 2022;24(3):42–50. doi: 10.15825/1995-1191-2022-3-42-50.
  • Singh V, Kumar P, Verma N, et al. Propranolol vs. band ligation for primary prophylaxis of variceal hemorrhage in cirrhotic patients with ascites: a randomized controlled trial. Hepatol Int. 2022;16(4):944–953. doi: 10.1007/s12072-022-10361-4.
  • Tittanegro T, China L, Forrest E, et al. Use of non-selective B-blockers is safe in hospitalised decompensated cirrhosis patients and exerts a potential anti-inflammatory effect: data from the ATTIRE trial. EClinicalMedicine. 2023;55:101716. doi: 10.1016/j.eclinm.2022.101716.
  • Bossen L, Krag A, Vilstrup H, et al. Nonselective β-blockers do not affect mortality in cirrhosis patients with ascites: post hoc analysis of three randomized controlled trials with 1198 patients. Hepatology. 2016;63(6):1968–1976. doi: 10.1002/hep.28352.
  • Bhutta AQ, Garcia-Tsao G, Reddy KR, et al. Beta-blockers in hospitalised patients with cirrhosis and ascites: mortality and factors determining discontinuation and reinitiation. Aliment Pharmacol Ther. 2018;47(1):78–85. doi: 10.1111/apt.14366.
  • Téllez L, Ibáñez-Samaniego L, Pérez Del Villar C, et al. Non-selective beta-blockers impair global circulatory homeostasis and renal function in cirrhotic patients with refractory ascites. J Hepatol. 2020;73(6):1404–1414. doi: 10.1016/j.jhep.2020.05.011.
  • Bai Z, Méndez-Sánchez N, Romeiro FG, et al. Use of albumin infusion for cirrhosis-related complications: an international position statement. JHEP Rep 2023;5(8):100785. doi: 10.1016/j.jhepr.2023.100785.
  • Facciorusso A, Roy S, Livadas S, et al. Nonselective Beta-Blockers do not affect survival in cirrhotic patients with ascites. Dig Dis Sci. 2018;63(7):1737–1746. doi: 10.1007/s10620-018-5092-6.
  • Velez JCQ, Therapondos G, Juncos LA. Reappraising the spectrum of AKI and hepatorenal syndrome in patients with cirrhosis. Nat Rev Nephrol. 2020;16(3):137–155. doi: 10.1038/s41581-019-0218-4.
  • Stanley AJ, Bouchier IA, Hayes PC. Acute effect of propranolol and isosorbide-5-mononitrate administration on renal blood flow in cirrhotic patients. Gut. 1998;42(2):283–287. doi: 10.1136/gut.42.2.283.
  • Morillas RM, Planas R, Cabré E, et al. Propranolol plus isosorbide-5-mononitrate for portal hypertension in cirrhosis: long-term hemodynamic and renal effects. Hepatology. 1994;20(6):1502–1508. doi: 10.1002/hep.1840200620.
  • Stanley AJ, Therapondos G, Helmy A, et al. Acute and chronic haemodynamic and renal effects of carvedilol in patients with cirrhosis. J Hepatol. 1999;30(3):479–484. doi: 10.1016/s0168-8278(99)80108-1.
  • Bataille C, Bercoff E, Pariente EA, et al. Effects of propranolol on renal blood flow and renal function in patients with cirrhosis. Gastroenterology. 1984;86(1):129–133. doi: 10.1016/0016-5085(84)90598-5.
  • Sersté T, Francoz C, Durand F, et al. Beta-blockers cause paracentesis-induced circulatory dysfunction in patients with cirrhosis and refractory ascites: a cross-over study. J Hepatol. 2011;55(4):794–799. doi: 10.1016/j.jhep.2011.01.034.
  • Wong F. The evolving concept of acute kidney injury in patients with cirrhosis. Nat Rev Gastroenterol Hepatol. 2015;12(12):711–719. doi: 10.1038/nrgastro.2015.174.
  • Turco L, Villanueva C, La Mura V, et al. Lowering portal pressure improves outcomes of patients with cirrhosis, with or without ascites: a meta-analysis. Clin Gastroenterol Hepatol. 2020;18(2):313–327.e316. doi: 10.1016/j.cgh.2019.05.050.
  • Tergast TL, Kimmann M, Laser H, et al. Systemic arterial blood pressure determines the therapeutic window of non-selective beta blockers in decompensated cirrhosis. Aliment Pharmacol Ther. 2019;50(6):696–706. doi: 10.1111/apt.15439.
  • Stadlbauer V, Wright GA, Banaji M, et al. Relationship between activation of the sympathetic nervous system and renal blood flow autoregulation in cirrhosis. Gastroenterology. 2008;134(1):111–119. doi: 10.1053/j.gastro.2007.10.055.
  • Kumar M, Kainth S, Choudhury A, et al. Treatment with carvedilol improves survival of patients with acute-on-chronic liver failure: a randomized controlled trial. Hepatol Int. 2019;13(6):800–813. doi: 10.1007/s12072-019-09986-9.
  • Kalambokis GN, Christaki M, Tsiakas I, et al. Conversion of propranolol to carvedilol improves renal perfusion and outcome in patients with cirrhosis and ascites. J Clin Gastroenterol. 2021;55(8):721–729. doi: 10.1097/MCG.0000000000001431.
  • Fierbinteanu-Braticevici C, Udeanu M, Dragomir P, et al. The effects of carvedilol a nonselective beta-blocker on portal hemodynamics in cirrhosis. Rom J Intern Med. 2003;41(3):247–254.