Control of malignant ascites with spironolactone

Thirteen of 15 patients with malignant ascites achieved an excellent response to spironolactone, with an increase in urinary sodium excretion rates from less than 35 mEq/d before treatment to between 50 and 245 mEq/d after treatment. Plasma renin activity was raised in all of 5 patients in whom it was measured, whereas aldosterone was raised in only 3; these results are similar to those found in ascites due to cirrhosis.