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A dose-response study of orally administered torsemide in patients with ascites due to cirrhosis
J J Applefeld1, R J Kasmer, L J Hak
1Critical Care Services, Good Samaritan Regional Medical Center, Phoenix, AZ 85006.
Background:
This study evaluated the dose-response relationship of torsemide, the first pyridine-sulphonylurea loop diuretic, in patients with ascites due to cirrhosis.
Methods:
During a 13-day hospitalization period, 17 patients received single, oral doses of 5 mg, 10 mg, or 20 mg of torsemide or placebo in a randomized, double-blind, crossover fashion. All the patients received a constant dose of spironolactone concomitantly beginning at least 7 days before the study. Electrolyte excretion and urine volume were measured for 24 h after each dose. Body weight was measured before, and 24 h after each dose.
Results:
Torsemide was effective in producing statistically significant, dose-related increases in urinary sodium and chloride excretion, with little effect on potassium or magnesium excretion. Urine volume increased and body weight decreased in a dose-related manner.
Conclusion:
Torsemide increased sodium excretion substantially in patients with cirrhosis and ascites who were receiving spironolactone.