Significance of aldosterone antagonism in the treatment of edema and ascites
| Autor: | J.M. Dyniewicz, Clarence L. Gantt, Robert E. Ecklund |
|---|---|
| Rok vydání: | 1962 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Urology Spironolactone Lactones chemistry.chemical_compound Hydrochlorothiazide Spirolactone Internal medicine medicine Edema Humans Spiro Compounds Diuretics Aldosterone Antihypertensive Agents Thiazide Mineralocorticoid Receptor Antagonists business.industry Ascites General Medicine Chlorothiazide Endocrinology chemistry Kaliuresis Diuretic business medicine.drug Antidiuretic |
| Zdroj: | The American Journal of Medicine. 33:490-500 |
| ISSN: | 0002-9343 |
| DOI: | 10.1016/0002-9343(62)90260-7 |
| Popis: | The response to spirolactone therapy was studied in forty-six patients with edema or ascites due to cirrhosis, congestive heart failure or the nephrotic syndrome. Twenty-seven of these patients were refractory to mercurial or thiazide diuretics. Approximately one third of this group had a significant diuresis with the administration of the spirolactone alone. This figure was increased to approximately 67 per cent when the spirolactones were given in combination with mercurial or thiazide diuretics. Simultaneous use of other diuretic technics in combination with the spirolactones and the thiazide diuretics produced a diuresis in all the patients who received them for longer than five days. The spirolactones of themselves usually did not cause kaliuresis and markedly diminished the potassium excretion due to the administration of thiazide diuretics. The sodium diuresis obtained with the simultaneous use of thiazide diuretics and spirolactones was usually much greater than the sum of that observed when the two agents were given alone. Complications of present therapy included dilutional hyponatremia, true low salt syndrome, hyperkalemia and a rise in the blood urea nitrogen. Our data conform to the view that aldosterone is important in the retention of sodium and water in patients with cirrhosis, severe congestive heart failure and the nephrotic syndrome. Blockade of this hormone appears to be a useful method of therapy in these patients. However, it is also quite clear that other antidiuretic mechanisms are operative too, especially in the so-called refractory patients. |
| Databáze: | OpenAIRE |
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