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Use of piretanide, a new loop diuretic in cirrhosis with ascites. Relationship between the diuretic response and the plasma aldosterone level

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dc.creator Arroyo, Vicente
dc.creator Bosch i Genover, Jaume
dc.creator Casamitjana i Abellà, Roser
dc.creator Cabrera, J.
dc.creator Rivera Fillat, Francisca
dc.creator Rodés, J.
dc.date 2011-07-07T12:30:24Z
dc.date 2011-07-07T12:30:24Z
dc.date 1980
dc.date.accessioned 2024-12-16T10:27:14Z
dc.date.available 2024-12-16T10:27:14Z
dc.identifier 0017-5749
dc.identifier http://hdl.handle.net/2445/18652
dc.identifier 22111
dc.identifier 7439805
dc.identifier.uri http://fima-docencia.ub.edu:8080/xmlui/handle/123456789/22124
dc.description Twenty patients with cirrhosis and ascites but no renal failure were given piretanide, a new loop diuretic, in order to investigate its efficacy and to relate the diuretic response with the pretreatment plasma aldosterone concentration. Eleven patients responded to piretanide 12 mg/day (equivalent in potency to 80 mg furosemide); there was no response in nine patients. Both groups were similar with regard to liver function, plasma urea, serum creatinine, plasma electrolytes, urine volume, and urine potassium concentration. The basal urinary sodium excretion was significantly higher in those patients who responded (23.6 +/- 5.7 mmol/day vs. 4.3 +/- 1.42 mmol/day; P < 0.01) (M +/- SE). Plasma renin activity (PRA) and plasma aldosterone concentration (PAC) were normal or only slightly increased in patients who responded to piretanide (PRA = 1.22 +/- 0.20 ng/ml/h; PAC = 12.25 +/- 2.20 ng/100 ml) and very high in patients who did not respond (PRA = 8.71 +/- 1.18 ng/ml/h; PAC = 84.6 +/- 16.2 ng/100 ml) (P < 0.001). Patients unresponsive to piretanide 12 mg/day also failed to respond when the dose was increased to 24 mg/day. However, the addition of spironolactone, 150 mg/day, to piretanide was followed in these patients by a marked increase in diuresis and natriuresis. These results strongly suggest that the pre-treatment level of aldosterone is an important factor influencing the response to loop diuretics in patients with non-azotaemic cirrhosis and ascites.
dc.format 5 p.
dc.format application/pdf
dc.language eng
dc.publisher BMJ Group
dc.relation Reproducció digital del document publicat a: http://dx.doi.org/10.1136/gut.21.10.855
dc.relation Gut, 1980, vol. 21, núm. 10, p. 855-859
dc.relation http://dx.doi.org/10.1136/gut.21.10.855
dc.rights (c) BMJ Publishing Group Ltd and British Society of Gastroenterology, 1980
dc.rights info:eu-repo/semantics/openAccess
dc.source Articles publicats en revistes (Medicina)
dc.subject Aldosterona
dc.subject Diürètics
dc.subject Cirrosi hepàtica
dc.subject Ascites
dc.subject Aldosterone
dc.subject Diuretics
dc.subject Hepatic cirrhosis
dc.subject Ascites
dc.title Use of piretanide, a new loop diuretic in cirrhosis with ascites. Relationship between the diuretic response and the plasma aldosterone level
dc.type info:eu-repo/semantics/article
dc.type info:eu-repo/semantics/publishedVersion


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