Ascites free-water dynamics in decompensated cirrhosis: effects of acute and chronic frusemide treatment.
OBJECTIVE
To evaluate the effects of acute (60 mg intravenous bolus) and protracted (75 mg per day orally for 1 week) frusemide administration on ascites volume, free-water peritoneal clearance (FWPC), intra-abdominal pressure (IAP) and body weight in 30 decompensated cirrhotic patients.


METHODS
Individual ascites volume and FWPC were estimated by means of a previously validated methylene-blue dilution test.


RESULTS
All the investigated parameters showed a significant reduction after the protracted diuretic treatment (ascites volume 9.0 +/- 1.0 to 4.9 +/- 0.61, P < 0.001; FWPC 99.8 +/- 6.7 to 76.2 +/- 6.6 ml/min, P < 0.001; IAP 17.0 +/- 1.5 to 11.3 +/- 0.8 cmH2O, P < 0.001; body weight 75.2 +/- 1.9 to 66.3 +/- 1.8 kg, P < 0.001). A significant FWPC reduction (89.5 +/- 14.6 to 68.8 +/- 12.1 ml/min, P < 0.02) was also observed after the acute frusemide administration in the absence of any appreciable modifications to ascites volumes and IAP.


CONCLUSIONS
Frusemide treatment appears to be able to exert a direct significant effect on FWPC, which does not appear to be mediated by ascites volume or IAP modifications.
D000005:Abdomen / Q000503:physiopathology; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology*; D001834:Body Water / Q000502:physiology; D001835:Body Weight; D005260:Female; D005665:Furosemide / Q000008:administration & dosage*; D006801:Humans; D007275:Injections, Intravenous; D008103:Liver Cirrhosis / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008751:Methylene Blue; D008875:Middle Aged; D010537:Peritoneum / Q000378:metabolism; D011312:Pressure
D005665:Furosemide; D008751:Methylene Blue