One-week losartan administration increases sodium excretion in cirrhotic patients with and without ascites |
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Authors: | Ying-Ying Yang Han-Chieh Lin Wui-Chiang Lee Ming-Chih Hou Fa-Yauh Lee Full-Young Chang Shou-Dong Lee |
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Institution: | (1) Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, No. 201, Sec. 2, Shih-Pai Road, Taipei 11217, Taiwan, TW |
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Abstract: | Background. Losartan, a highly selective angiotensin II type 1 receptor antagonist, has been reported to have a significant portal hypotensive
effect in cirrhotic patients. A recent study also showed that losartan exerted a dramatic natriuretic effect in preascitic
cirrhosis. The influence of losartan on renal hemodynamics and sodium homeostasis in cirrhotic patients with ascites is unclear.
This study was undertaken to evaluate the renal effects of 1-week losartan treatment in cirrhotic patients with and without
ascites. Methods. All 12 patients in the study received a daily oral dose of 25 mg losartan for 7 consecutive days. Effective renal plasma
flow, urine volume, creatinine clearance, 24h urine sodium excretion and fractional excretion of sodium, blood urea nitrogen,
and serum creatinine were measured before and after treatment. Results. In cirrhotic patients without ascites, creatinine clearance, 24-h urinary sodium excretion, and fractional excretion of sodium
were significantly increased after losartan administration. Effective renal plasma flow and serum creatinine showed almost
no change after treatment. In cirrhotic patients with ascites, creatinine clearance, 24-h urinary sodium excretion, fractional
excretion of sodium, and effective renal plasma flow were significantly increased after losartan administration. In addition,
the magnitudes of the increases in the fractional excretion of sodium and in the 24-h urinary sodium excretion were greater
in cirrhotic patients with ascites than in those without ascites. Conclusions. One-week treatment with losartan increases sodium excretion in association with an improvement of renal function in cirrhotic
patients with and without ascites. The natriuretic effect was more profound in cirrhotic patients with ascites than in those
without ascites.
Received: May 1, 2001 / Accepted: August 24, 2001 |
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Keywords: | : angiotensin II ascites cirrhosis losartan |
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