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Ascites free-water dynamics in decompensated cirrhosis: effects of acute and chronic frusemide treatment
A Milani1, A M Ciammella, L Rossi
1Institute of Medical Pathology, Università Cattolica del Sacro Cuore, Rome, Italy.
Objective:
To evaluate the effects of acute (60 mg intravenous bolus) and protracted (75 mg per day orally for 1 week) frusemide administration on ascites volume, free-water peritoneal clearance (FWPC), intra-abdominal pressure (IAP) and body weight in 30 decompensated cirrhotic patients.
Methods:
Individual ascites volume and FWPC were estimated by means of a previously validated methylene-blue dilution test.
Results:
All the investigated parameters showed a significant reduction after the protracted diuretic treatment (ascites volume 9.0 +/- 1.0 to 4.9 +/- 0.61, P < 0.001; FWPC 99.8 +/- 6.7 to 76.2 +/- 6.6 ml/min, P < 0.001; IAP 17.0 +/- 1.5 to 11.3 +/- 0.8 cmH2O, P < 0.001; body weight 75.2 +/- 1.9 to 66.3 +/- 1.8 kg, P < 0.001). A significant FWPC reduction (89.5 +/- 14.6 to 68.8 +/- 12.1 ml/min, P < 0.02) was also observed after the acute frusemide administration in the absence of any appreciable modifications to ascites volumes and IAP.
Conclusion:
Frusemide treatment appears to be able to exert a direct significant effect on FWPC, which does not appear to be mediated by ascites volume or IAP modifications.