[Biological factors influencing response to diuretics in patients with cirrhosis and ascites].
OBJECTIVE
To examine the biological factors influencing response to diuretics in patients with cirrhosis and ascites.


METHODS
Sixty-nine patients were evaluated. Patients were classified into 3 groups: group 1: "good responders" (responding to spironolactone 200 mg/day), group 2: "bad responders" (responding to spironolactone doses above 200 mg/day or requiring addition of furosemide), and group 3: "non-responders" (not responding to spironolactone 400 mg/day and furosemide 160 mg/day).


RESULTS
There were 30 patients in group 1, 24 in group 2 and 15 in group 3. The degree of activation of the renin-aldosterone and sympathetic system in group 2 was significantly higher than in group 1 and lower than in group 3. Natriuresis in group 2 (11 +/- 0.7 mEq/24h) was significantly below group 1 (20 +/- 2 mEq/24h) and above group 3 (5 +/- 0.6 mEq/24h).


CONCLUSIONS
In patients with cirrhosis and ascites, the degree of activation of the renin-aldosterone and sympathetic nervous system influences diuretic response of ascites and is estimated by measured baseline natriuresis.
Lenaerts
A
A
Service Universitaire d'Hépato-Gastroentérologie, CHU, Charleroi, B-6000 Belgique, Paris, France.
Codden
T
T
Henry
J P
JP
Van Cauter
J
J
Meunier
J C
JC
Ligny
G
G
D000450:Aldosterone / Q000097:blood; D001201:Ascites / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D004232:Diuretics / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005665:Furosemide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D005919:Glomerular Filtration Rate; D006801:Humans; D006947:Hyperkalemia / Q000139:chemically induced; D007010:Hyponatremia / Q000139:chemically induced; D008103:Liver Cirrhosis / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009318:Natriuresis; D009638:Norepinephrine / Q000097:blood; D012083:Renin / Q000097:blood; D012084:Renin-Angiotensin System / Q000187:drug effects / Q000502:physiology; D013148:Spironolactone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D013564:Sympathetic Nervous System / Q000187:drug effects / Q000503:physiopathology; D016896:Treatment Outcome
D004232:Diuretics; D013148:Spironolactone; D000450:Aldosterone; D005665:Furosemide; D012083:Renin; D009638:Norepinephrine