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Pregled bibliografske jedinice broj: 316402

Časopis

Autori: Ljubičić, Neven; Kujundžić, Milan; Banić, Marko; Vrkljan, Milan
Naslov: Predictive factors influencing the therapeutic response to diuretic treatment of ascites in nonazotemic cirrhotic patients
( Predictive factors influencing the therapeutic response to diuretic treatment of ascites in nonazotemic cirrhotic patients )
Izvornik: Scandinavian Journal of Gastroenterology (0036-5521) 33 (1998), 4; 441-447
Vrsta rada: članak
Ključne riječi: ascites; cirrhosis; diuretics
( ascites; cirrhosis; diuretics )
Sažetak:
A low-sodium diet and diuretics, although widely used, are not always the most satisfactory therapy for treatment of ascites in nonazotemic patients with liver cirrhosis. The objective of this investigation was to analyze various predictive factors influencing the therapeutic response to diuretic treatment of ascites in these patients. Methods: Twenty-seven patients with nonazotemic liver cirrhosis and ascites were initially treated with spironolactone, 200 mg/day. If no response was observed, furosemide was added at 40-120 mg/day. Before and during the diuretic therapy 30 clinical and laboratory variables were investigated as possible predictive factors influencing the therapeutic response to diuretics. The renal arterial resistive index (RI) (reflecting renal vascular resistance) was estimated with duplex Doppler ultrasonography. Results: Sixteen of the 27 patients (59%) responded to spironolactone alone, whereas 6 patients (22%) responded to combined diuretic therapy with spironolactone and furosemide. Five patients (19%) did not respond to diuretic treatment. Eight of the 30 variables analyzed were statistically significant as possible predictive factors influencing the diuretic response: previous episodes of ascites and gastrointestinal hemorrhage, the presence of peripheral edema, the amount of ascites, plasma renin activity, plasma aldosterone concentrations, urinary sodium excretion, and renal interlobar arterial RI. In all patients who had diuretic-resistant ascites, renal interlobar arterial RI was greater than 0.70. Only 9% of patients who responded satisfactorily to diuretic therapy had interlobar arterial RI greater than 0.70. Conclusions: According to our results, consideration for combining the clinical findings with noninvasively measured renal arterial RI using duplex Doppler ultrasonography would be mandatory in identifying a subgroup of cirrhotic patients with ascites who are at high risk for diuretic unresponsiveness.
Izvorni jezik: eng
Rad je indeksiran u
bazama podataka:
Current Contents Connect (CCC)
MEDLINE
Scopus
SCI-EXP, SSCI i/ili A&HCI
Science Citation Index Expanded (SCI-EXP) (sastavni dio Web of Science Core Collectiona)
Kategorija: Znanstveni
Znanstvena područja:
Kliničke medicinske znanosti
URL cjelovitog teksta:
Google Scholar: Predictive factors influencing the therapeutic response to diuretic treatment of ascites in nonazotemic cirrhotic patients
Upisao u CROSBI: Marko Banić (mbanic@zagreb.kbd.hr), 4. Sij. 2008. u 14:02 sati



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