PMID: 9536956Apr 16, 1998Paper

Acute effect of propranolol and isosorbide-5-mononitrate administration on renal blood flow in cirrhotic patients

Gut
A J StanleyP C Hayes

Abstract

Propranolol and isosorbide-5-mononitrate (ISMN) are increasingly used in the prophylaxis of variceal haemorrhage in cirrhosis. However, recent studies have suggested that these drugs may compromise renal function, possibly by reducing renal blood flow. To assess the acute effects of propranolol and ISMN on renal blood flow and other haemodynamic parameters in cirrhosis. Twenty six cirrhotic patients were given either 80 mg propranolol, 20 mg ISMN, or a combination of the two drugs. Unilateral renal blood flow (RBF), azygos blood flow (AZBF), hepatic venous pressure gradient (HVPG), mean arterial pressure (MAP), and heart rate (HR) were recorded prior to and one hour after drug administration. Propranolol caused a reduction in HR (p < 0.005), AZBF (p < 0.01), and HVPG (p = 0.05), but no change in MAP or RBF (454.1 (77.3) versus 413.9 (60.3) ml/min). ISMN reduced MAP (p < 0.005) and HVPG (p < 0.01), but had no effect on HR, AZBF, or RBF (302.5 (49.4) versus 301.7 (58.8) ml/min). Combined treatment reduced MAP (p < 0.005), AZBF (p < 0.05), and HVPG (p = 0.002), but HR and RBF (419.2 (62.6) versus 415.1 (61.1) ml/min) remained unchanged. Despite the anticipated changes in other haemodynamic parameters, acute propranolol and/or ISMN...Continue Reading

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Citations

Apr 1, 1999·The New England Journal of Medicine·A K Burroughs, D Patch
Nov 22, 2007·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Aleksander KragFlemming Bendtsen
Oct 30, 2016·Disease-a-month : DM·Eula Plana TetangcoEdgar V Lerma
May 1, 2001·Alimentary Pharmacology & Therapeutics·A Helmy, P C Hayes

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