Moderate ascites may be treated using spironolactone, either alone or in combination with furosemide. However, it is unclear which treatment is preferable.
In this study, 100 nonazotemic cirrhotic patients with moderate ascites were randomized to received either spironolactone and furosemide (group 1), or with spironolactone alone (group 2).
The research team's findings are published in the August issue of the Journal of Hepatology.
|The need to reduce the diuretic dosage was less for spironolactone alone.|
|Journal of Hepatology|
The team increased the dose up to 400 mg/day for spironolactone and 160 mg/day for furosemide, if no response occurred.
Furthermore, where patients in group 2 failed to respond to 400 mg/day of spironolactone, furosemide was added.
In cases with an excessive response, the dosage of diuretics was reduced.
The physicians found a response rate of 98% in group 1 and 94% in group 2.
They determined that the rapidity of ascites mobilization, and the incidence of complications induced by diuretic therapy was similar in both groups.
However, the need to reduce the diuretic dosage was significantly higher in group 1 than group 2, 68% versus 34%, respectively.
Dr Justiniano Santos's team concluded, "In the treatment of moderate ascites, spironolactone alone seems to be as safe and effective as spironolactone associated with furosemide".
"Since spironolactone alone requires less dose adjustment, it would be more suitable for treating ascites on an outpatient basis".