Effects of losartan, somatostatin and losartan plus somatostatin on portal hemodynamics and renal functions in cirrhosis.
OBJECTIVE
Several drugs have been used to reduce portal hypertension. Losartan constitutes arteriolar and venous vasodilation by inhibiting the effects of the increased angiotensin II in cirrhotic patients. In this study, we analyzed the effects of losartan, when used alone and when combined with somatostatin, on portal and renal hemodynamics.


METHODS
Seventeen patients with cirrhosis were enrolled. During the study, the patients were administered 250 micrograms of somatostatin i.v. bolus and subsequent infusion at a rate of 250 micrograms/hr for 2 hours on the second day; 25 mg losartan orally on the fourth day; and losartan and somatostatin together, in the same doses as the second and the fourth day, were given on the sixth day.


RESULTS
The portal flow volume and the velocity that were measured after the administration of somatostatin, losartan and the combination of each drug, were found to be increased when compared with the initial values (P < 0.001). Additionally, the creatinine clearances were increased and statistically significant with somatostatin.


CONCLUSIONS
Considering its low cost, easy usability, long lasting effect, we suggest that losartan can be used as an alternative treatment in the clinical conditions where portal pressure should be reduced and can be combined with somatostatin without any significant adverse effects.
Hülagü
Saadettin
S
Department of Gastroenterology, Kocaeli University, Faculty of Medicine, Kocaeli, Turkey. shulagu@hotmail.com
Sentürk
Omer
O
Erdem
Aysun
A
Ozgür
Orhan
O
Celebi
Altay
A
Karakaya
A Turgut
AT
Seyhogullari
Mualla
M
Demirci
Ali
A
D000328:Adult; D000959:Antihypertensive Agents / Q000494:pharmacology*; D004359:Drug Therapy, Combination; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006728:Hormones / Q000494:pharmacology*; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000503:physiopathology*; D019808:Losartan / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D011168:Portal System / Q000187:drug effects / Q000503:physiopathology*; D012039:Regional Blood Flow / Q000187:drug effects; D013004:Somatostatin / Q000494:pharmacology*
D000959:Antihypertensive Agents; D006728:Hormones; D013004:Somatostatin; D019808:Losartan