{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:53:12Z","timestamp":1777510392552,"version":"3.51.4"},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T00:00:00Z","timestamp":1702252800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Midodrine, an oral \u03b1\u20101\u2010adrenergic receptor agonist, counters arterial hypovolemia and reduces complications in adult patients with cirrhosis. This randomized controlled trial (RCT) aimed to assess the efficacy and safety of midodrine in preventing complications and improving survival in children with cirrhosis and ascites who are awaiting liver transplantation (LT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This open\u2010label RCT conducted from January 2022 to May 2023 included children under 18 years with cirrhosis and ascites. Patients were randomized to receive either midodrine plus standard medical therapies (SMTs) or SMT alone. The primary outcome measure was the incidence of cirrhosis\u2010related complications within 6 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010five subjects were enrolled and randomized. Patients in the midodrine arm had a lower incidence of new\u2010onset acute kidney injury (AKI) compared with the SMT arm (11.1% vs. 41.2%). Patients in the midodrine arm showed a decline in serum creatinine and improvement in glomerular filtration rate, whereas no changes were observed in the SMT arm. There was a lower incidence of new\u2010onset hyponatremia in the midodrine arm (20% vs. 56%). Midodrine led to reduction in plasma rennin activity (PRA) and improvement in systemic hemodynamics. There was no difference in the rate of resolution of ascites, recurrence of ascites, requirement of therapeutic paracentesis, cumulative albumin infusion requirement, episodes of spontaneous bacterial peritonitis, and hepatic encephalopathy between the two arms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Midodrine, when added to SMT, was effective in reducing the incidence of new\u2010onset AKI and hyponatremia in pediatric cirrhotics awaiting LT. It also improved systemic hemodynamics and showed a trend towards reducing PRA.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jpn3.12077","type":"journal-article","created":{"date-parts":[[2023,12,16]],"date-time":"2023-12-16T10:04:12Z","timestamp":1702721052000},"page":"350-359","source":"Crossref","is-referenced-by-count":1,"title":["Midodrine reduces new\u2010onset acute kidney injury and hyponatremia in children with cirrhosis and ascites awaiting liver transplantation: Results from an open\u2010label RCT"],"prefix":"10.1002","volume":"78","author":[{"given":"A.","family":"Ashritha","sequence":"first","affiliation":[{"name":"Department of Pediatric Hepatology and Cardiology Section Institute of Liver and Biliary Sciences New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bikrant B.","family":"Lal","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hepatology and Cardiology Section Institute of Liver and Biliary Sciences New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajeev","family":"Khanna","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hepatology and Cardiology Section Institute of Liver and Biliary Sciences New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vikrant","family":"Sood","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hepatology and Cardiology Section Institute of Liver and Biliary Sciences New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arun K.","family":"Sood","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hepatology and Cardiology Section Institute of Liver and Biliary Sciences New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seema","family":"Alam","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hepatology and Cardiology Section Institute of Liver and Biliary Sciences New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,12,11]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.05.004"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.9"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-3231.2008.01778.x"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2011.04.027"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.08.006"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/1751-2980.12304"},{"issue":"7","key":"e_1_2_11_8_1","article-title":"Midodrine in liver cirrhosis with ascites: a systematic review and Meta\u2010Analysis","volume":"14","author":"Shrestha DB","year":"2022","journal-title":"Cureus"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1979.121"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-021-04076-1"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc11454"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510230122"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-3231.2008.01734.x"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2006.09.012"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27709"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2021.675948"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000000743"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2014.04.012"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951120004746"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2014.04.032"}],"container-title":["Journal of Pediatric Gastroenterology and Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jpn3.12077","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T06:53:04Z","timestamp":1723445584000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jpn3.12077"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,11]]},"references-count":19,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1002\/jpn3.12077"],"URL":"https:\/\/doi.org\/10.1002\/jpn3.12077","archive":["Portico"],"relation":{},"ISSN":["0277-2116","1536-4801"],"issn-type":[{"value":"0277-2116","type":"print"},{"value":"1536-4801","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,11]]}}}