title: Bumetanide, spironolactone and a combination of the two, in the treatment of ascites due to liver disease. A prospective, controlled, randomized trial.
abstract: There are few studies available comparing the efficacy of loop and distal diuretics and a combination of the two groups, in the treatment of ascites due to liver disease. Thirty-seven nonazotemic cirrhotic patients with ascites were randomly allocated to receive for 2 weeks bumetanide (group A, n = 13), spironolactone (group B, n = 12) or a combination of the two drugs (group C, n = 12) after a 5-day stabilization period. The response to the treatment was 69, 42 and 83% in groups A, B and C, respectively; the difference was not significant. Hypokalemia was seen in 4 patients of group A and mild hyperkalemia in 2 patients of group B. Electrolyte disturbances were minimal in patients of group C. The response to diuretic treatment was prompt in groups A and C. It can be concluded that a combination of loop and distal diuretics is superior to a one-drug regimen in achieving a rapid and better diuretic response with fewer side effects.
authors.affiliation: Department of Gastroenterology and Biochemistry, G.B. Pant Hospital, New Delhi, India.
authors.forename: S K
authors.initials: SK
authors.lastname: Sarin
authors.forename: G
authors.initials: G
authors.lastname: Sachdev
authors.forename: S P
authors.initials: SP
authors.lastname: Mishra
authors.forename: K R
authors.initials: KR
authors.lastname: Sundaram
authors.forename: A
authors.initials: A
authors.lastname: Shrivastwa
authors.forename: V
authors.initials: V
authors.lastname: Talukdar
authors.forename: S L
authors.initials: SL
authors.lastname: Broor
mesh_terms: D000284:Administration, Oral; D000328:Adult; D001201:Ascites / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D002034:Bumetanide / Q000008:administration & dosage / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004232:Diuretics / Q000627:therapeutic use*; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000378:metabolism; D011446:Prospective Studies; D011897:Random Allocation; D012964:Sodium / Q000378:metabolism; D013148:Spironolactone / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D004232:Diuretics; D004338:Drug Combinations; D002034:Bumetanide; D013148:Spironolactone; D012964:Sodium; D011188:Potassium