The effects of treatment with octreotide, diuretics, or both on portal hemodynamics in nonazotemic cirrhotic patients with ascites

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dc.contributor.authorKalambokis, G.en
dc.contributor.authorEconomou, M.en
dc.contributor.authorKosta, P.en
dc.contributor.authorPapadimitriou, K.en
dc.contributor.authorTsianos, E. V.en
dc.date.accessioned2015-11-24T19:41:36Z
dc.date.available2015-11-24T19:41:36Z
dc.identifier.issn0192-0790-
dc.identifier.urihttps://olympias.lib.uoi.gr/jspui/handle/123456789/24508
dc.rightsDefault Licence-
dc.subjectAdulten
dc.subjectAgeden
dc.subjectAldosterone/blooden
dc.subjectAscites/etiologyen
dc.subjectDiuretics/*therapeutic useen
dc.subjectDrug Therapy, Combinationen
dc.subjectFemaleen
dc.subjectFurosemide/*therapeutic useen
dc.subjectGastrointestinal Agents/*pharmacologyen
dc.subjectHemodynamics/drug effectsen
dc.subjectHumansen
dc.subjectLiver Cirrhosis/*drug therapy/*physiopathologyen
dc.subjectMaleen
dc.subjectMiddle Ageden
dc.subjectOctreotide/*pharmacologyen
dc.subjectPortal System/*drug effects/*physiopathologyen
dc.subjectPortal Vein/ultrasonographyen
dc.subjectRenin/blooden
dc.subjectRenin-Angiotensin System/drug effectsen
dc.subjectSpironolactone/*therapeutic useen
dc.subjectUltrasonography, Doppleren
dc.titleThe effects of treatment with octreotide, diuretics, or both on portal hemodynamics in nonazotemic cirrhotic patients with ascitesen
heal.abstractGOALS: To evaluate the effects of diuretic treatment, octreotide, or both on portal hemodynamics in nonazotemic cirrhotic patients with ascites. BACKGROUND: Diuretics and octreotide have been associated with a decrease in portal pressure in cirrhotic patients, suggested to be mediated by plasma volume depletion and splanchnic vasoconstriction, respectively. However, liver cirrhosis is characterized by activation of the renin-angiotensin-aldosterone axis, which increases hepatic vascular resistance and is augmented or suppressed by diuretics or octreotide, respectively. STUDY: Twenty nonazotemic cirrhotic patients with ascites were treated with furosemide and spironolactone. Of them, 10 (group 1) discontinued diuretic treatment for 7 days. Thereafter for 5 days, each patient received subcutaneous octreotide, 300 microg twice per day; ten of them (group 2) received the octreotide in addition to their usual diuretic treatment. Portal and systemic hemodynamics with Doppler ultrasound and endogenous vasoactive systems were evaluated while the patients received diuretics (both groups), after discontinuation of diuretics (group 1), and after octreotide administration (both groups). RESULTS: The withdrawal of diuretics did not alter portal hemodynamics, but it impaired systemic hemodynamics and suppressed the renin-aldosterone axis. The addition of octreotide to diuretic treatment but not octreotide alone improved portal and systemic hemodynamics. In both groups the initiation of octreotide administration suppressed the renin-aldosterone axis and plasma glucagon levels. CONCLUSIONS: In nonazotemic cirrhotic patients with ascites, the combination of diuretics and octreotide improves systemic hemodynamics and inhibits the diuretic-related component of the activated renin-aldosterone axis, which in turn augments the portal hypotensive effect of diuretic-induced plasma volume depletion.en
heal.accesscampus-
heal.fullTextAvailabilityTRUE-
heal.identifier.primary10.1097/01.mcg.0000210101.74618.61-
heal.identifier.secondaryhttp://www.ncbi.nlm.nih.gov/pubmed/16633107-
heal.journalNameJ Clin Gastroenterolen
heal.journalTypepeer-reviewed-
heal.languageen-
heal.publicationDate2006-
heal.recordProviderΠανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικήςel
heal.typejournalArticle-
heal.type.elΆρθρο Περιοδικούel
heal.type.enJournal articleen

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