[Effect of captopril therapy on sodium and water excretion in patients with liver cirrhosis and ascites]

Klin Wochenschr. 1989 Aug 1;67(15):774-83. doi: 10.1007/BF01745350.
[Article in German]


Ascites in patients with cirrhosis of the liver frequently is refractory to diuretic treatment. It was postulated that vasoconstriction of the renal cortex, mediated by activation of the renin-angiotensin-aldosterone-system (RAAS), may be one course of the disturbed sodium- and water-excretion in these patients. We therefore investigated in 14 cirrhotic patients with ascites under constant diuretic treatment the effects of low-dose captopril therapy on urinary sodium- and potassium-excretion, body weight, abdominal girth, serum-sodium, -potassium, creatinine-clearance, plasma-renin-activity (PRA), plasma-aldosterone (PA) and mean arterial pressure (MAP). After a control period of 4 days the patients received 2 x 6.25 mg/d captopril for 5 days and 4 x 6.25 mg/d for further 5 days. Treatment was followed by a second control period without captopril. PRA increased significantly after 2 days of captopril treatment. 2 x 6.25 mg/d captopril induced a significant increase in sodium excretion and a significant decrease of body weight. MAP decreased slightly but significantly without clinical signs of hypotension. 4 x 6.25 mg/d captopril resulted in a further reduction of body weight and a further enhancement of sodium excretion. Three days after withdrawal of captopril sodium output was significantly reduced again.

Conclusion: In cirrhotic patients low-dose captopril seems to be efficient in the treatment of ascites resistant to diuretics without causing major side effects.

Publication types

  • English Abstract

MeSH terms

  • Adult
  • Aged
  • Ascites / drug therapy*
  • Blood Pressure / drug effects
  • Captopril / administration & dosage*
  • Diuresis / drug effects*
  • Diuretics
  • Dose-Response Relationship, Drug
  • Drug Therapy, Combination
  • Female
  • Furosemide / administration & dosage
  • Glomerular Filtration Rate / drug effects
  • Humans
  • Hydrochlorothiazide / administration & dosage
  • Hydrochlorothiazide / analogs & derivatives
  • Liver Cirrhosis / drug therapy*
  • Male
  • Middle Aged
  • Renin-Angiotensin System / drug effects
  • Sodium Chloride Symporter Inhibitors / administration & dosage
  • Spironolactone / administration & dosage
  • Water-Electrolyte Balance / drug effects*


  • Diuretics
  • Sodium Chloride Symporter Inhibitors
  • Hydrochlorothiazide
  • Spironolactone
  • Furosemide
  • Captopril
  • buthiazide