[251] Effects of Prolonged Administration of Midodrine in the Treatment of Diuretic-Resistant Ascitis: A Pilot Study

Prevention of paracentesis‐induced circulatory dysfunction: midodrine vs albumin. A randomized pilot study

“…The second study evaluated the efficacy of midodrine in the treatment of diuretic‐resistant ascites with a daily dose slightly lower than the one applied in our study, but administered over a longer time. The study suggests that midodrine may reduce ascites production (17). Thus, the efficacy of midodrine may not only be dependent on the daily dose but also on the duration of drug administration.…”

Midodrine and furosemide-induced natriuresis in cirrhotics with ascites

“…First, midodrine increases natriuresis by causing splanchnic arterial vasoconstriction, which improves systemic haemodynamics and consequently, effective arterial blood volume and renal plasma flow (RPF) 2 . Such beneficial systemic haemodynamic effects were documented in previous single‐dose 3 and multiple‐dose 4–6 midodrine studies on non‐azotemic cirrhotics with ascites, which consistently showed improvement in renal function and a significant increase in natriuresis, but not in the study of Misra et al. Moreover, midodrine exerts variable effects in these patients.…”

Vasoconstrictor therapy for patients with cirrhosis with ascites but without hepatorenal syndrome

“…Preliminary work from our group 1,2 and other investigators 3,4 showed that the a1 adrenergic agonist midodrine improves systemic hemodynamics and renal function, and suppresses the activity of antinatriuretic factors, such as renin-aldosterone axis and sympathetic nervous system, in patients with cirrhosis with ascites but without hepatorenal syndrome (HRS). A preferential effect of midodrine on splanchnic vasculature has been suggested experimentally, 5 and by the fact that the peripheral arterial resistance is not modified under midodrine treatment in non-HRS patients with cirrhosis with ascites, 3 despite the systemic hemodynamic improvement.…”