Bumetanide, spironolactone and a combination of the two, in the treatment of ascites due to liver disease. A prospective, controlled, randomized trial

Digestion. 1988;41(2):101-7. doi: 10.1159/000199738.

Abstract

There are few studies available comparing the efficacy of loop and distal diuretics and a combination of the two groups, in the treatment of ascites due to liver disease. Thirty-seven nonazotemic cirrhotic patients with ascites were randomly allocated to receive for 2 weeks bumetanide (group A, n = 13), spironolactone (group B, n = 12) or a combination of the two drugs (group C, n = 12) after a 5-day stabilization period. The response to the treatment was 69, 42 and 83% in groups A, B and C, respectively; the difference was not significant. Hypokalemia was seen in 4 patients of group A and mild hyperkalemia in 2 patients of group B. Electrolyte disturbances were minimal in patients of group C. The response to diuretic treatment was prompt in groups A and C. It can be concluded that a combination of loop and distal diuretics is superior to a one-drug regimen in achieving a rapid and better diuretic response with fewer side effects.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adult
  • Ascites / drug therapy*
  • Ascites / etiology
  • Ascites / metabolism
  • Bumetanide / administration & dosage
  • Bumetanide / therapeutic use*
  • Clinical Trials as Topic
  • Diuretics / therapeutic use*
  • Double-Blind Method
  • Drug Combinations
  • Female
  • Humans
  • Liver Cirrhosis / complications*
  • Male
  • Middle Aged
  • Potassium / metabolism
  • Prospective Studies
  • Random Allocation
  • Sodium / metabolism
  • Spironolactone / administration & dosage
  • Spironolactone / therapeutic use*

Substances

  • Diuretics
  • Drug Combinations
  • Bumetanide
  • Spironolactone
  • Sodium
  • Potassium