Effects of low-sodium diet and spironolactone on portal pressure in patients with compensated cirrhosis

✍ Scribed by Juan Carlos García-Pagán; Juan Manuel Salmerón; Faust Feu; Angelo Luca; Pere Ginés; Pilar Pizcueta; Juan Claria; Carlos Piera; Vicente Arroyo; Jaume Bosch; Juan Rodés

• Publisher: John Wiley and Sons
• Year: 1994
• Tongue: English
• Weight: 575 KB
• Volume: 19
• Category: Article
• ISSN: 0270-9139
• DOI: 10.1002/hep.1840190506

✦ Synopsis

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 m m Hg to 15.3 & 3.5 ( -20% +-20%), cardiac output ( -16.2% 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% k 6%) and in mean arterial pressure (-4% -+ 6%). 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.