Cavallin 2016.

Methods	Open label, multicentre randomised clinical trial.
Participants	Criteria used to define hepatorenal syndrome:Salerno 2007 (Appendix 2). Type 1 hepatorenal syndrome = 44 participants included. Type 2 hepatorenal syndrome = 4 participants included. Demographics: Terlipressin group: mean age 60 years, men 78%, viral aetiology 37%. Other vasoactive drug group: mean age 65 years, men 52%, viral aetiology 38%.
Interventions	Terlipressin: Administration form: continuous intravenous infusion. Dose: dose titration regimen. Initial dose 3 mg/24 hours. With no response, dose primarily increased to 6 mg/24 hours and then to 12 mg/24 hours. Response defined as a reduction of serum creatinine of ≥ 25% compared to baseline after every 48 hours of treatment. Other vasoactive drugs:midodrine and octreotide Midodrine Administration form: oral tablet. Dose: dose titration regimen. Initial dose 7.5 mg/8 hours. With no response, dose increased to 12.5 mg/8 hours. Response defined as a reduction in serum creatinine of ≥ 25% from baseline after 3 days of treatment. Octreotide Administration form: subcutaneous bolus injection. Dose: dose titration regimen. Initial dose 100 mg/8 hours. With no response, dose increased to 200 mg/8 hours. Response defined as a reduction in serum creatinine of ≥ 25% from baseline after 3 days of treatment. Cointervention: both arms treated with albumin; 1 g/kg bodyweight at day 1, followed by 20 g/day to 40 g/day.
Outcomes	Primary: reversal of hepatorenal syndrome. Secondary: 3 months survival.
Treatment duration	Treatment duration: until reversal of hepatorenal syndrome, death, or a maximum of 14 days. Follow‐up: 3 months.
Country of origin	Italy.
Inclusion period	2008 to 2012.
Notes	Full paper.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Computer‐generated allocation sequence.
Allocation concealment (selection bias)	Low risk	Serially numbered opaque sealed envelopes.
Blinding of participants and personnel (performance bias) All outcomes	High risk	No blinding of participants or personnel.
Blinding of outcome assessment (detection bias) All outcomes	High risk	No blinding of outcome assessment.
Incomplete outcome data (attrition bias) All outcomes	Low risk	No missing outcome data and all participants were accounted for.
Selective reporting (reporting bias)	Low risk	Clinically relevant outcomes reported. No differences between trial registration/protocol and published paper identified.
For‐profit bias	Low risk	Authors declared no conflict of interests and the trial did not receive funding from for‐profit organisations.
Overall risk of bias (non‐mortality outcomes)	High risk
Overall risk of bias (mortality)	Low risk