Diuretic Therapy in Patients with Cirrhosis

  • Sheila Sherlock

Summary

The mechanism of ascites formation in patients with cirrhosis is outlined. Control requires rigid dietary sodium chloride restriction, limitation of fluid intake and diuretics in various doses and combinations.

One hundred and thirty seven patients with cirrhosis and ascites were treated with dietary sodium restriction and various diuretics alone and in combination. Ascites could be controlled in 130 patients. Failures were in those with particularly severe hepato-cellular failure. In mild cases frusemide alone was adequate. In more severe cases of fluid retention the combination of frusemide with amiloride proved satisfactory. Potassium chloride supplements were given as required. Complications of diuretic therapy included hypokalaemia, hyponatraemia, hypochloraemic alkalosis and azotaemia. The incidence of hypochloraemic alkalosis and of precoma was low when amiloride was used with frusemide.

The importance of adjusting the dose and frequency of diuretic administration is stressed. If large doses of potent diuretics are given to patients with cirrhosis renal failure may be precipitated.

Keywords

Albumin Sodium Chloride Morphine Bicarbonate Mannitol 

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References

  1. Casey, T. H., W. H. J. Summebskill and A. L. Obvis: Gastroenterology 48, 198 (1965).PubMedGoogle Scholar
  2. Heckeb, R. and S. Sheblock: Lancet 11, 1121 (1956).CrossRefGoogle Scholar
  3. Kassibeb, J. P., P. M. Bebkman, D. R. Lawbenz and W. B. Schwabtz: Amer. J. Med. 38, 172 (1965).CrossRefGoogle Scholar
  4. Lancestbemebe, R. G., P. L. Davidson, L. E. Eably, J. J. O’Bblen and S. Pappeb: J. clin. Invest. 41, 1922 (1962).CrossRefGoogle Scholar
  5. Liebebman, F. L. and T. B. Reynolds: Gastroenterology, 49, 531 (1965).Google Scholar
  6. Read, A. E., R. M. Haslam, J. Laidlaw and S. Sheblock: Clin. Sci. 18, 409 (1959).PubMedGoogle Scholar
  7. Schboedeb, E. T., L. Sheab, S. M. Sancetta and G. J. Gabttzda: Amer. J. Med., 43, 887 (1967).CrossRefGoogle Scholar
  8. Senewibatne, B. and S. Sheblock: Lancet I, 120 (1968).CrossRefGoogle Scholar
  9. Sheab, L., P. W. Hall III and G. J. Gabuzda: Amer. J. Med., 39, 199 (1965).CrossRefGoogle Scholar
  10. Sheblock, S.: Diseases of the liver and biliary system. 4th edition. Blackwell, Oxford, p. 138 (1968).Google Scholar
  11. Sheblock, S. and S. Shaldon: Gut, 4, 95 (1963).CrossRefGoogle Scholar
  12. Sheblock, S., B. Senewibatne, A. Scott and J. G. Walkeb: Lancet I, 1049 (1966).CrossRefGoogle Scholar
  13. Wabben, K. S., F. L. Ibeb, W. Dölle and S. Sheblock: J. Lab. clin. Med., 56, 678 (1960).Google Scholar
  14. Welch, H. F., C. S. Welch and J. H. Cabteb: Surgery 56, 75 (1964).PubMedGoogle Scholar
  15. Wilkinson, P. and S. Sheblock: Lancet II, 1125 (1962).CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin · Heidelberg 1969

Authors and Affiliations

  • Sheila Sherlock

There are no affiliations available

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