Effekte einer Captopriltherapie auf die Natrium- und Wasserausscheidung bei Patienten mit Leberzirrhose und Aszites |
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Authors: | R Brunkhorst E Wrenger K Kühn F W Schmidt K Koch |
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Institution: | (1) Abteilung Nephrologie Zentrums Innere Medizin der Medizinischen Hochschule Hannover, Germany;(2) Gastroenterologie des Zentrums Innere Medizin der Medizinischen Hochschule Hannover, Germany;(3) Medizinische Klinik im Klinikum Karlsruhe, Germany |
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Abstract: | Summary Ascites in patients with cirrhosis of the liver frequently is refractory to diuretic treatment. It was postulated that vasoconstriction of the renal cortex, mediated by activation of the renin-angiotensin-aldosterone-system (RAAS), may be one course of the disturbed sodium- and water-excretion in these patients. We therefore investigated in 14 cirrhotic patients with ascites under constant diuretic treatment the effects of low-dose captopril therapy on urinary sodium- and potassium-excretion, body weight, abdominal girth, serum-sodium,-potassium, creatinine-clearance, plasma-renin-activity (PRA), plasma-aldosterone (PA) and mean arterial pressure (MAP). After a control period of 4 days the patients received 2 × 6.25 mg/d captopril for 5 days and 4 × 6.25 mg/d for further 5 days. Treatment was followed by a second control period without captopril.PRA increased significantly after 2 days of captopril treatment. 2 × 6.25 mg/d captopril induced a significant increase in sodium excretion and a significant decrease of body weight. MAP decreased slightly but significantly without clinical signs of hypotension. 4 × 6.25 mg/d captopril resulted in a further reduction of body weight and a further enhancement of sodium excretion. Three days after withdrawal of captopril sodium output was significantly reduced again. Conclusion: In cirrhotic patients low-dose captopril seems to be efficient in the treatment of ascites resistant to diuretics without causing major side effects. Abkürzungen ACE
Angiotensin-Converting-Enzym
- A-II
Angiotensin II
- CH
2
O
Frei-Wasser-Clearance
- CKrea
Kreatinin-Clearance
- COsmo
Osmolale Clearance
- g
Gramm
- h
Stunde
- kg
Kilogramm
- l/d
Liter pro Tag
- MAP
Mittlerer arterieller Blutdruck
- mg
Milligramm
- mg/d
Milligramm pro Tag
- ml/min
Milliliter pro Minute
- mmHg
Millimeter Quecksilbersäule (Torr)
- mmol/d
Millimol pro Tag
- NaCl
Natriumchlorid
- ng/ml/h
Nanogramm pro Milliliter und Stunde
- PA
Plasma-Aldosteron
- pg/ml
Picogramm pro Milliliter
- PRA
Plasma-Renin-Aktivität
- RAAS
Renin-Angiotensin-Aldosteron-System
- SEM
Standardfehler des Mittelwertes
- SKrea
Kreatininkonzentration im Serum
- SOsm
Serum-Osmolalität
- UKrea
Kreatininkonzentration im Urin
- UOsm
Urin-Osmolalität
- V
Urinminutenvolumen
- vgl.
vergleiche
- µmol/l
Micromol pro Liter |
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Keywords: | Liver cirrhosis Ascites Renin-angictensin-aldosterone-system Renal functional impairment Sodium excretion Captopril |
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