TY - JOUR
T1 - Effects of low-sodium diet and spironolactone on portal pressure in patients with compensated cirrhosis
AU - García-Pagán, Juan Carlos
AU - Salmerón, Juan Manuel
AU - Feu, Faust
AU - Luca, Angelo
AU - Ginés, Pere
AU - Pizcueta, Pilar
AU - Claria, Juan
AU - Piera, Carlos
AU - Arroyo, Vicente
AU - Bosch, Jaume
AU - Rodés, Juan
PY - 1994/5
Y1 - 1994/5
N2 - 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.
AB - 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.
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U2 - 10.1016/0270-9139(94)90855-9
DO - 10.1016/0270-9139(94)90855-9
M3 - Article
C2 - 8175131
AN - SCOPUS:0028212762
VL - 19
SP - 1095
EP - 1099
JO - Hepatology
JF - Hepatology
SN - 0270-9139
IS - 5
ER -