Effect Of β Adrenergic Blocking Drugs on the Renin-Aldosterone System, Sodium Excretion, and Renal Hemodynamics in Cirrhosis With Ascites

Wilkinson, Stephen; Bernardi, M.; Smith, I. K.; Jowett, T.P.; Slater, J. D. H.; Williams, Roger

doi:10.1016/s0016-5085(19)31761-5

Cited by 58 publications

(9 citation statements)

References 19 publications

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“…Plasma aldosterone concentration was 11 showed a tendency to be grouped in the lower level of the normal range so that the cirrhotics' mean plasma aldosterone concentration was significantly reduced compared with controls (p<0.005). Most patients appeared to be in sodium balance (urinary sodium excretion from 38 to 49 mmol/day), but five showed a clear negative balance (from 55 to 90 mmol/day), and two a positive one (24 and 27 mmol/day).…”

Section: Resultsmentioning

confidence: 96%

Aldosterone related blood volume expansion in cirrhosis before and during the early phase of ascites formation.

Bernardi¹,

Trevisani²,

Santini³

et al. 1983

Gut

101

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SUMMARY Thirty-seven patients with liver cirrhosis (16 without ascites: group 1; 21 with untreated ascites at the first onset: group 2) were studied during controlled sodium intake (40 mmol/day). Renal plasma flow, glomerular filtration rate, urinary sodium excretion, plasma sodium and potassium, plasma renin activity, plasma aldosterone concentration, blood volume, and arterial pressure were evaluated. All the patients had normal renal perfusion, plasma sodium and potassium, and arterial pressure. Mean plasma renin activity and plasma aldosterone concentration were significantly depressed in group 1 (p<0.001, p<0005 respectively) compared with 21 normal controls in identical experimental conditions. This was possibly a consequence of expanded blood volume (p

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Section: Resultsmentioning

confidence: 96%

Aldosterone related blood volume expansion in cirrhosis before and during the early phase of ascites formation.

Bernardi¹,

Trevisani²,

Santini³

et al. 1983

Gut

101

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“…Interestingly, propranolol alone exerted a diuretic effect in our BDL rats. Propranolol diuretic effect could be explained by its suppression of renin release in the kidney, which promotes less tubular water reabsorption, reflected in an increase in diuresis. However, an antinatriuretic effect of propanolol has also been described in patients with cirrhosis and ascites receiving diuretics .…”

Section: Discussionmentioning

confidence: 99%

The renal effects of droxidopa are maintained in propranolol treated cirrhotic rats

Rodriguez

Raurell

Ezkurdia

et al. 2014

Liver International

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“…Underlying cirrhosis was histologically confirmed in all cases. At the time of trial design, there was considerable concern about possible adverse effects of propranolol in patients with decompensated liver disease (14). Therefore tients classed as Pugh grade C (15) were excluded, as were those with specific contraindications to P-adrenoreceptor blockade.…”

Section: Methodsmentioning

confidence: 99%

A controlled trial of oral propranolol compared with injection sclerotherapy for the long-term magnagement of variceal bleeding

et al. 1990

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This trial was carried out to assess the value of propranolol for the prevention of recurrent variceal bleeding in patients with well-compensated cirrhosis. We also compared propranolol therapy to long-term injection sclerotherapy. One hundred and eight patients, in whom the original variceal hemorrhage stopped spontaneously (before diagnostic endoscopy) and without sclerotherapy or surgical intervention, were included. All were Pugh grade A or B; 55% had alcoholic cirrhosis. Patients were chosen randomly to receive oral propranolol (in a dosage to reduce resting pulse rate by 25%) or to undergo long-term injection sclerotherapy. In both groups, episodes of repeat bleeding that did not stop spontaneously were managed with sclerotherapy. Patients considered to have failed propranolol therapy were treated with long-term sclerotherapy. Follow-up ranged from 12 to 64 mo. In the propranolol group, 28 (54%) of the 52 patients had repeat bleeding from varices with a total of 57 episodes; 14 received long-term sclerotherapy. In the sclerotherapy group, 25 (45%) of the 56 patients had repeat bleeding, with a total of 40 episodes (p less than 0.20). On an intention-to-treat basis, the risk of bleeding expressed per patient-month of follow-up was similar for the two groups, at 0.05 and 0.037, respectively. Survival as assessed by cumulative life analysis was also similar, with 55% and 66% alive at 3 yr (p less than 0.40). Stepwise regression analysis of possible factors predicting further bleeding in patients taking propranolol selected only two variables--the pretreatment pulse rate and the extent of pulse-rate reduction in response to propranolol.(ABSTRACT TRUNCATED AT 250 WORDS)

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Effect Of β Adrenergic Blocking Drugs on the Renin-Aldosterone System, Sodium Excretion, and Renal Hemodynamics in Cirrhosis With Ascites

Cited by 58 publications

References 19 publications

Aldosterone related blood volume expansion in cirrhosis before and during the early phase of ascites formation.

Aldosterone related blood volume expansion in cirrhosis before and during the early phase of ascites formation.

The renal effects of droxidopa are maintained in propranolol treated cirrhotic rats

A controlled trial of oral propranolol compared with injection sclerotherapy for the long-term magnagement of variceal bleeding

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