PMID: 44911Dec 1, 1979

Diuretic-induced renal impairment without volume depletion in cirrhosis: changes in the renin-angiotensin system and the effect of beta-adrenergic blockade

Postgraduate Medical Journal
S P WilkinsonR Williams

Abstract

In 4 patients with cirrhosis and ascites, diuretic therapy resulted in an impairment of renal function that was associated with a rise in plasma renin activity (PRA). In 3, this occurred in the absence of volume depletion. When diuretics were discontinued, renal function returned to normal. beta-adrenergic blocking drugs were then given to suppress renin secretion and diuretics restarted. On this occasion, impairment of renal function did not occur. In 2 further patients, administration of beta-adrenergic blockers during a period of diuretic-induced renal impairment resulted in an improvement in renal function. Although these findings may indicate that diuretic-induced renal impairment in cirrhosis is at least partly due to activation of the renin-angiotensin system, in another group of patients a diuretic-induced rise in PRA was not associated with a deterioration in renal function.

References

Nov 1, 1985·Toxicology and Applied Pharmacology·M E Kyle, J J Kocsis
Sep 10, 1983·British Medical Journal·P C HayesI A Bouchier
Nov 1, 1981·Journal of Clinical Pathology·S P Wilkinson
May 1, 1986·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·M BernardiG Gasbarrini
Sep 1, 1993·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·J H Henriksen, H Ring-Larsen
Mar 1, 1985·Journal of Clinical and Hospital Pharmacy·D Clements, E Elias

Citations

Jan 9, 1975·The New England Journal of Medicine·E L BravoH P Dustan
Dec 11, 1976·British Medical Journal·S P WilkinsonR Williams
Feb 1, 1977·Clinical Science and Molecular Medicine·J L ImbsJ Schwartz
Aug 1, 1977·Chemical & Pharmaceutical Bulletin·H IshiiY Inatsu
Jun 1, 1976·Kidney International·E T SchroederD H Streeten
Apr 6, 1976·Pflügers Archiv : European journal of physiology·J SchnermannM Hermle
Jan 1, 1976·Physiological Reviews·J O Davis, R H Freeman
Aug 1, 1975·Postgraduate Medical Journal·J RodésV Arroyo
Sep 1, 1969·The Journal of Clinical Endocrinology and Metabolism·N WinerA D Freedman
Jun 1, 1974·The Journal of Clinical Investigation·F S Wright, J Schnermann
Jun 18, 1970·The New England Journal of Medicine·L ShearG J Gabuzda
Aug 1, 1971·The American Journal of Physiology·C G DuarteG Giebisch
Apr 1, 1969·The American Journal of Physiology·R A MogilJ J Murphy
Jun 1, 1966·Annals of Internal Medicine·F L Lieberman, T B Reynolds

Related Concepts

Kidney Function Tests
Kidney Failure
Carmol
Renin-Angiotensin Pathway
Spiro von ct
Cirrhosis
Salix - substance
Fibrosis, Liver
Kidney
Process of Secretion

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