[Effects of acute octreotide infusion on renal function in patients with cirrhosis and portal hypertension].

نویسندگان

  • Guillermo Silva
  • Roberto Segovia
  • Claudia Backhouse
  • Mariana Palma
  • Sylvia Márquez
  • Hernán Iturriaga
چکیده

BACKGROUND Octreotide is used in the treatment of acute variceal bleeding, based on its inhibitory effects of post-prandial splanchnic hyperemia and splanchnic venoconstriction. The consequences of these haemodynamic changes on renal circulation are not well known in cirrhotic patients. AIM To evaluate the effects of acute octreotide administration on several parameters of renal function, including free water clearance, in patients with cirrhosis with or without ascites. PATIENTS AND METHODS Twenty cirrhotic patients, Child-Pugh A orB, with or without ascites, with esophageal varices, normal renal function and free of medications (vasoactive drugs or diuretics) were assigned to 2 different protocols. Protocol 1: 10 patients were randomized to receive octreotide or placebo, as a bolus followed by a continuous infusion. Glomerular filtration rate (GFR) and renal plasma flow (PRF) were measured, in basal conditions and during the drug or placebo administration. Protocol 2: 10 additional patients were randomized in the same way and free water clearance and urinary sodium excretion were again measured in the basal period and during the drug or placebo infusion. RESULTS After octreotide or placebo administration no significant changes were observed neither in GFR nor in PRF. The free water clearance decreased significantly during octreotide administration (3.12 ml/min+/-1.04 SE vs 0.88+/-0.39, p<.03). In both protocols no changes in mean arterial pressure were observed. CONCLUSIONS Acute administration of octreotide to cirrhotic patients with portal hypertension, with or without ascites, did not produce any change in glomerular filtration rate or in estimated renal plasm blood flow. However the free water clearance decreased significantly. This effect, under chronic administration, could be clinically important and deserves further studies.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Pharmacokinetics of Octreotide in Patients With Cirrhosis and Portal Hypertension; Relationship Between the Plasma Levels of the Analogue and the Magnitude and Duration of the Reduction in Corrected Wedged Hepatic Venous Pressure

In healthy subjects octreotide is largely metabolised by the liver suggesting that the plasma half-life of the somatostatin analogue may be prolonged in patients with hepatic dysfunction. The aim of this study was therefore (a) to determine the pharmacokinetics of octreotide following its subcutaneous injection in 6 patients with cirrhosis and portal hypertension and (b) compare the magnitude a...

متن کامل

Serelaxin as a potential treatment for renal dysfunction in cirrhosis: Preclinical evaluation and results of a randomized phase 2 trial

BACKGROUND Chronic liver scarring from any cause leads to cirrhosis, portal hypertension, and a progressive decline in renal blood flow and renal function. Extreme renal vasoconstriction characterizes hepatorenal syndrome, a functional and potentially reversible form of acute kidney injury in patients with advanced cirrhosis, but current therapy with systemic vasoconstrictors is ineffective in ...

متن کامل

Evaluation of Therapeutic Effects of Autologous Bone Marrow Mesenchymal Stem Cells to Prevent the Progression of Chronic Nephropathy in Renal Transplant

Background Chronic allograft nephropathy(CAN)  is one of the most common causes of chronic and end stage renal disease. It  is defined with Mainly tubular atrophy and  interstitial fibrosis and no evidence of any other etiology, or functional disorder that caused at least three months after transplantation . Control of risk factors (HTN,DM,HLP, …) and limiting  usage of calcineurin inhibitors...

متن کامل

گزارش یک مورد توده کاذب مدیاستن در یک بیمار سیروتیک

We report a case of paraesophageal varices presenting as a posterior mediastinal mass in a patient with long-standing portal hypertension and cirrhosis. The case is unusual because the varices were considerably larger than those usually encountered in portal hypertension. This report is a reminder that portal hypertension with paraesophageal varices can present as a retrocardiac mass on...

متن کامل

بررسی مقایسه ای پاراسنتز آسیت شدید در افراد سیروتیک با و بدون استفاده از آلبومین وریدی

Introduction: It has been shown that repeated large volume paracenthesis associated with intravenous albumin infusion is a rapid, effective and safe therapy of massive ascites in cirrhosis. Our aim was to investigate wether IV infusion of albumin is necessary in large volume paeacenthesis therapy of cirrhotic ascites. Methods: 37 patients with tense cirrhotic ascites who were intractable to diu...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:
  • Revista medica de Chile

دوره 132 2  شماره 

صفحات  -

تاریخ انتشار 2004