title: Effects of low-sodium diet and spironolactone on portal pressure in patients with compensated cirrhosis.
abstract: The aim of this study was to investigate the hemodynamic effects of spironolactone associated with a low-sodium diet (n = 14) or a low-sodium diet alone (n = 9) in patients with compensated cirrhosis and portal hypertension. Spironolactone significantly reduced the plasma volume. This effect was associated with a significant reduction in the hepatic venous pressure gradient, from 17.6 +/- 3.6 mm Hg to 15.3 +/- 3.5 mm Hg (-13% +/- 13%; p < 0.01). Azygos blood flow (-20% +/- 20%), cardiac output (-16.2% +/- 10.5%) and mean arterial pressure (-9% +/- 9%) also decreased significantly. However, there were no significant changes in hepatic blood flow. Patients receiving low-sodium diet alone experienced a mild but significant reduction in hepatic venous pressure gradient (-6.3% +/- 6%) and in mean arterial pressure (-4% +/- 5%). There were no significant changes in cardiac output and in hepatic or azygos blood flows. This study indicates that low-sodium diet plus administration of spironolactone reduces portal pressure and azygos blood flow in patients with compensated cirrhosis. Low-sodium diet alone only produces mild effects that are likely to be clinically irrelevant.
authors.affiliation: Liver Unit, Hospital Clinic and Provincial, University of Barcelona, Spain.
authors.forename: J C
authors.initials: JC
authors.lastname: García-Pagán
authors.forename: J M
authors.initials: JM
authors.lastname: Salmerón
authors.forename: F
authors.initials: F
authors.lastname: Feu
authors.forename: A
authors.initials: A
authors.lastname: Luca
authors.forename: P
authors.initials: P
authors.lastname: Ginés
authors.forename: P
authors.initials: P
authors.lastname: Pizcueta
authors.forename: J
authors.initials: J
authors.lastname: Claria
authors.forename: C
authors.initials: C
authors.lastname: Piera
authors.forename: V
authors.initials: V
authors.lastname: Arroyo
authors.forename: J
authors.initials: J
authors.lastname: Bosch
mesh_terms: D000368:Aged; D001401:Azygos Vein / Q000503:physiopathology; D003131:Combined Modality Therapy; D004039:Diet, Sodium-Restricted; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006503:Hepatic Veins / Q000503:physiopathology; D006801:Humans; D006975:Hypertension, Portal / Q000178:diet therapy* / Q000188:drug therapy* / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000178:diet therapy* / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow / Q000187:drug effects; D013148:Spironolactone / Q000627:therapeutic use*; D014690:Venous Pressure / Q000187:drug effects
chemical_list: D013148:Spironolactone