Renal effects of treatment with diuretics, octreotide or both, in non-azotemic cirrhotic patients with ascites

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dc.contributor.authorKalambokis, G.en
dc.contributor.authorEconomou, M.en
dc.contributor.authorFotopoulos, A.en
dc.contributor.authorBokharhii, J. A.en
dc.contributor.authorKatsaraki, A.en
dc.contributor.authorTsianos, E. V.en
dc.date.accessioned2015-11-24T18:54:23Z
dc.date.available2015-11-24T18:54:23Z
dc.identifier.issn0931-0509-
dc.identifier.urihttps://olympias.lib.uoi.gr/jspui/handle/123456789/18677
dc.rightsDefault Licence-
dc.subjectAdulten
dc.subjectAgeden
dc.subjectChylous Ascites/*drug therapy/urineen
dc.subjectDiuretics/*therapeutic useen
dc.subjectDrug Therapy, Combinationen
dc.subjectFemaleen
dc.subjectFurosemide/therapeutic useen
dc.subjectGastrointestinal Agents/*therapeutic useen
dc.subjectGlomerular Filtration Rateen
dc.subjectHemodynamics/drug effectsen
dc.subjectHumansen
dc.subjectInjections, Subcutaneousen
dc.subjectKidney/*drug effectsen
dc.subjectKidney Function Testsen
dc.subjectLiver Cirrhosis/*drug therapy/urineen
dc.subjectMaleen
dc.subjectMiddle Ageden
dc.subjectOctreotide/*therapeutic useen
dc.subjectSodium/metabolismen
dc.subjectSpironolactone/therapeutic useen
dc.subjectWater/metabolismen
dc.titleRenal effects of treatment with diuretics, octreotide or both, in non-azotemic cirrhotic patients with ascitesen
heal.abstractBACKGROUND: Diuretic-induced hyperreninaemia is associated with renal dysfunction in cirrhotic patients with ascites, and in turn prevents the use of high doses of diuretics. Furthermore, ample evidence suggests that octreotide can inhibit the activation of the renin-aldosterone axis. The present study investigated the renal effects of the addition of octreotide to furosemide and spironolactone in the treatment of non-azotemic cirrhotic patients with ascites. METHODS: We studied 20 patients 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 b.i.d., in 10 patients (Group 2) in addition to their usual diuretics. We collected data on the patients while they received diuretics (both groups), after discontinuation of diuretics (Group 1), and after octreotide administration (both groups). RESULTS: We observed a trend to increase creatinine clearance and a significant reduction in plasma active renin and plasma aldosterone after the discontinuation of diuretics. The subsequent introduction of octreotide reduced glomerular filtration rate, although it significantly decreased plasma active renin and plasma aldosterone. In contrast, the addition of octreotide to diuretic treatment significantly increased glomerular filtration rate, urine volume and sodium excretion. The magnitudes of the decreases in plasma-active renin and aldosterone produced by the combination of octreotide and diuretics were similar to those produced by octreotide alone or by the discontinuation of diuretics. CONCLUSIONS: Octreotide alone does not improve renal function in cirrhotic patients with ascites. On the contrary, adding it to diuretic treatment increases glomerular filtration rate and sodium and water excretion, mainly through the suppression of an activated renin-aldosterone axis.en
heal.accesscampus-
heal.fullTextAvailabilityTRUE-
heal.identifier.primary10.1093/ndt/gfh871-
heal.identifier.secondaryhttp://www.ncbi.nlm.nih.gov/pubmed/15886218-
heal.identifier.secondaryhttp://ndt.oxfordjournals.org/content/20/8/1623.full.pdf-
heal.journalNameNephrol Dial Transplanten
heal.journalTypepeer-reviewed-
heal.languageen-
heal.publicationDate2005-
heal.recordProviderΠανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικήςel
heal.typejournalArticle-
heal.type.elΆρθρο Περιοδικούel
heal.type.enJournal articleen

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