AIM To assess the effects of a combination therapy with natriuretic and aquaretic drugs in cirrhotic ascites patients.METHODS A two-center,randomized,open-label,prospective study was conducted. Japanese patients who m...AIM To assess the effects of a combination therapy with natriuretic and aquaretic drugs in cirrhotic ascites patients.METHODS A two-center,randomized,open-label,prospective study was conducted. Japanese patients who met the criteria were randomized to trial group and the combination diuretic group(received 7.5 mg of tolvaptan) or the conventional diuretic group(received 40 mg of furosemide) for 7 d in addition to the natriuretic drug which was used prior to enrolment in this study. The primary endpoint was the change in body weight from the baseline. Vital signs,fluid intake,and laboratory and urinary data were assessed to determine the pharmacological effects after administration of aquaretic and natriuretic drugs.RESULTS A total of 56 patients were randomized to receive either tolvaptan(n = 28) or furosemide(n = 28). In the combination and conventional diuretic groups,the average decrease in body weight from the baseline was 3.21 ± 3.17 kg(P < 0.0001) and 1.75 ± 2.36 kg(P = 0.0006),respectively,when measured on the final dosing day. Following 1 wk of treatment,a significantly greater reduction in body weight was observed in the combination diuretic group compared to that in the conventional diuretic group(P = 0.0412).CONCLUSION Compared to a conventional diuretic therapy with only a natriuretic drug,a combination diuretic therapy with natriuretic and aquaretic drugs is more effective for patients with cirrhotic ascites.展开更多
AIM： To evaluate the accuracy of spot urinary Na/K and Na/creatinine （Cr） ratios as an alternative to 24-h urinary sodium in monitoring dietary compliance in patients with liver cirrhosis and ascites treated with d...AIM： To evaluate the accuracy of spot urinary Na/K and Na/creatinine （Cr） ratios as an alternative to 24-h urinary sodium in monitoring dietary compliance in patients with liver cirrhosis and ascites treated with diuretics. METHODS： The study was carried on 40 patients with liver cirrhosis and ascites treated with diuretic therapy. Patients were divided into two groups according to 24-h urinary sodium. We measured spot urine Na/K ratio, Na/ Cr ratio and 24-h urinary sodium. Student＇s t test was used to compare the interval variables and x^2 test to compare the nominal variables between the two groups. Receiver operator characteristic curve was used to identify the best cutoff point for Na/K and Na/Cr ratio. RESULTS： The best cutoff point for Na/K ratio was 2.5 （P 〈 0.001） and area under the curve （AUC） was 0.9, and for Na/Cr ratio, the best cutoff point was 35 （P 〈 0.001） and AUC was 0.885. Na/K ratio showed higher sensitivity and accuracy compared to Na/Cr ratio （87.5% and 87% for Na/K ratio; 81% and 85% for Na/Cr ratio, respectively）. CONCLUSION： Spot urine Na/K ratio has adequate accuracy for assessment of dietary sodium restriction compared with 24-h urinary sodium in patients with liver cirrhosis and ascites.展开更多
文摘AIM To assess the effects of a combination therapy with natriuretic and aquaretic drugs in cirrhotic ascites patients.METHODS A two-center,randomized,open-label,prospective study was conducted. Japanese patients who met the criteria were randomized to trial group and the combination diuretic group(received 7.5 mg of tolvaptan) or the conventional diuretic group(received 40 mg of furosemide) for 7 d in addition to the natriuretic drug which was used prior to enrolment in this study. The primary endpoint was the change in body weight from the baseline. Vital signs,fluid intake,and laboratory and urinary data were assessed to determine the pharmacological effects after administration of aquaretic and natriuretic drugs.RESULTS A total of 56 patients were randomized to receive either tolvaptan(n = 28) or furosemide(n = 28). In the combination and conventional diuretic groups,the average decrease in body weight from the baseline was 3.21 ± 3.17 kg(P < 0.0001) and 1.75 ± 2.36 kg(P = 0.0006),respectively,when measured on the final dosing day. Following 1 wk of treatment,a significantly greater reduction in body weight was observed in the combination diuretic group compared to that in the conventional diuretic group(P = 0.0412).CONCLUSION Compared to a conventional diuretic therapy with only a natriuretic drug,a combination diuretic therapy with natriuretic and aquaretic drugs is more effective for patients with cirrhotic ascites.
文摘AIM： To evaluate the accuracy of spot urinary Na/K and Na/creatinine （Cr） ratios as an alternative to 24-h urinary sodium in monitoring dietary compliance in patients with liver cirrhosis and ascites treated with diuretics. METHODS： The study was carried on 40 patients with liver cirrhosis and ascites treated with diuretic therapy. Patients were divided into two groups according to 24-h urinary sodium. We measured spot urine Na/K ratio, Na/ Cr ratio and 24-h urinary sodium. Student＇s t test was used to compare the interval variables and x^2 test to compare the nominal variables between the two groups. Receiver operator characteristic curve was used to identify the best cutoff point for Na/K and Na/Cr ratio. RESULTS： The best cutoff point for Na/K ratio was 2.5 （P 〈 0.001） and area under the curve （AUC） was 0.9, and for Na/Cr ratio, the best cutoff point was 35 （P 〈 0.001） and AUC was 0.885. Na/K ratio showed higher sensitivity and accuracy compared to Na/Cr ratio （87.5% and 87% for Na/K ratio; 81% and 85% for Na/Cr ratio, respectively）. CONCLUSION： Spot urine Na/K ratio has adequate accuracy for assessment of dietary sodium restriction compared with 24-h urinary sodium in patients with liver cirrhosis and ascites.
