الفهرس 
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Abstract
HRS continues to be a challenging task to manage following chronic liver cirrhosis. The grave prognosis and the short survival times have fueled great interest in clinical trials; its reversibility creates scope for prolonging both survival and quality of life.
The current literature reviewed has further re-enforced terlipressin as a potential first line treatment in HRS. Terlipressin has so far shown to increase survival rates and reverse functional renal failure.
The increased neurohormonal response, especially of the RAAS, has been decreased with the administration of terlipressin. This subsequently improves circulatory dysfunction and lowers plasma creatinine levels near to baseline values. The effects of nitric oxide, which is a factor in the deleterious neurohormonal response, appears to be overcome by the administration of terlipressin through unknown mechanisms.
In addition, terlipressin has few adverse side effects, which allow patients to continue on treatment in order to achieve desirable effects.
However, at the present time there are a limited number of randomized, controlled studies carried out on terlipressin and therefore, there is a real need for large multi-centered trials to be carried out.
It is recommended that terlipressin, with concomitant administration of albumin, may be the first line treatment in the management of HRS for further investigation with clinical study on large scale.