Ibrahim ES, et al. - The role of rifaximin as a primary prevention of hepatorenal syndrome (HRS) was assessed in this study. The researchers found that as a primary prevention of HRS, rifaximin could be useful.

• The researchers enrolled 80 patients with liver cirrhosis and ascites.
• They randomized patients into 2 groups: control (n=40) and rifaximin group (n=40).
• They carried out baseline liver function tests, renal function tests, complete blood count, international normalized ratio, urine analysis, and abdominal ultrasonography.
• For 12 weeks, rifaximin 550 mg was administered twice daily.
• They measured renal functions every 4 weeks with monitoring of HRS occurrence and possible precipitating factor.

• The researchers matched both groups for age, sex, virology, serum bilirubin, serum albumin, aspartate aminotransferase, alanine aminotransferase, hemoglobin, white blood cells, platelets, international normalized ratio, potassium, and Child–Pugh score.
• The control group demonstrated statistically significant serial blood urea nitrogen (18.84±7.17, 19.85±6.10, 21.54±4.79, and 22.96±5.82 mg/dl; P=0.001) and serum creatinine (0.94±0.25, 1.02±0.24, 1.12±0.16, and 1.21±0.17 mg/dl; P=0.001) levels in contrast to the rifaximin group.
• In the control group, the overall blood urea nitrogen and serum creatinine change was statistically higher compared to the rifaximin group (20.8 vs. 18.24 mg/dl and 1.07 vs. 0.99 mg/dl, respectively).
• In the control group, HRS developed more than the rifaximin group [9 (22.5%) vs. 2 (5%); P=0.048].
• HRS was precipitated by spontaneous bacterial peritonitis mainly and large volume paracentesis in both groups.
• Predictors of HRS were the Child–Pugh score, control group, baseline serum sodium, and creatinine.