Effects of single dose of 50mg captopril in patients with liver cirrhosis and ascites.
OBJECTIVE
In patients with liver cirrhosis and ascites, the renin angiotensin system is usually activated. Such a correlation supports the hypothesis that activation of the renin-angiotensin system plays an influential role in the pathogenesis of ascites in liver cirrhosis.


METHODS
In this study, 25 patients with liver cirrhosis and ascites (10 females, 15 males; age: 45-67 years) were enrolled. We evaluated the acute effects of converting enzyme inhibitor (a single dose of 50 mg captopril taken orally) on glomerular filtration rate, effective renal plasma flow, filtration fraction, plasma renin activity, and plasma aldosterone.


RESULTS
Oral intake of a single 50 mg dose of captopril significantly decreased glomerular filtration rate (65 +/- 6 mL/min/1.73 m2 vs. 53 +/- 9 mL/min/1.73 m2), filtration fraction (21.2 +/- 2.7% vs. 15.5 +/- 4.1%), and plasma aldosterone (340 +/- 80 pg/mL vs. 247 +/- 42 pg/mL), but increased plasma renin activity (2.65 +/- 2.19 ng/mL/hr vs. 11.58 +/- 2.70 ng/mL/hr) and effective renal plasma flow (312 +/- 41 mL/min/1.73 vs. 356 +/- 60 mL/min/1.73 m2).


CONCLUSIONS
We suggest that oral intake of a single dose of 50 mg captopril can block the renin-angiotension system, and result in changes in renal hemodynamics and function in cirrhotic patients with ascites.
Lee
J K
JK
Department of Nuclear Medicine, China Medical College Hospital, Taichung, Taiwan.
Hsieh
J F
JF
Tsai
S C
SC
Ho
Y J
YJ
Kao
C H
CH
D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000097:blood; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage*; D001201:Ascites / Q000503:physiopathology*; D002216:Captopril / Q000008:administration & dosage*; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012083:Renin / Q000097:blood; D012084:Renin-Angiotensin System / Q000187:drug effects*
D000806:Angiotensin-Converting Enzyme Inhibitors; D000450:Aldosterone; D002216:Captopril; D012083:Renin