Chronic splanchnic hemodynamic effects of spironolactone with unrestricted sodium diet in patients with compensated cirrhosis

Digestive Diseases and Sciences
S SuganoN Takamura

Abstract

The purpose of this study is to determine the hemodynamic effects of spironolactone administration associated with an unrestricted sodium diet (salt 10 g) in patients with compensated cirrhosis and portal hypertension. We studied the hemodynamic changes following eight weeks of administration of either placebo (N = 6) or spironolactone (100 mg/day) (N = 6 Pugh-Child's A and 6 B). No significant changes were observed after the administration of the placebo. Spironolactone induced a significant reduction in the hepatic venous pressure gradient (HVPG) (-10.1 +/- 13.3%, P < 0.05), which was associated with a significant reduction of cardiac output (-11.5 +/- 9.3%, P < 0.01), plasma volume (-8.1 +/- 4.7%, P < 0.01), and wedged hepatic venous pressure (-10.5 +/- 11.6%, P < 0.05). There was no significant change in hepatic blood flow and there was no significant correlation between the change in the HVPG and the change in circulating plasma volume. A decrease in the HVPG greater than 10% was observed in eight of 12 patients (67%), defined as responders, at eight weeks. Six of six (100%) grade A patients and two of six (33%) grade B patients responded. This study demonstrated that spironolactone with an unrestricted sodium diet decreas...Continue Reading

Citations

Feb 24, 2001·Alimentary Pharmacology & Therapeutics·D Tripathi, P C Hayes
Jan 24, 2003·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Raquel AbecasisRuben Terg
Apr 25, 2006·Journal of Clinical Gastroenterology·Georgios KalambokisEpameinondas V Tsianos
Jun 19, 2018·Journal of Clinical Gastroenterology·Chu Kion YaoVictoria Ping Yi Tan
May 25, 2002·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Giorgio La VillaPaolo Gentilini
May 30, 2003·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Carlo Merkel
Feb 21, 2018·The Korean Journal of Internal Medicine·Kwang Yong ShimSoon Koo Baik
Apr 22, 2005·The American Journal of Gastroenterology·Massimo PozziGiuseppe Mancia
Mar 29, 2012·BMC Gastroenterology·David G Levitt, Michael D Levitt

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