Complications of diuresis in the alcoholic patient with ascites: a controlled trial

Gastroenterology. 1977 Sep;73(3):534-8.

Abstract

Forty-three patients with decompensated alcoholic liver disease and ascites of recent onset were randomized to salt and water restriction alone (control group) or to salt and water restriction plus diuretics (diuresis group). The two treatment groups were comparable in clinical findings and laboratory results. Seven patients in the control group and 5 patients in the diuresis group died during the acute illness. Weight loss was more marked and the disappearance of ascites more common in those given diuretics. A modest decrease in serum sodium and increase in serum potassium, and readily reversible elevations of blood urea nitrogen were noted in the diuresis group. Eight patients in each treatment group developed either the hepatorenal syndrome, marked electrolyte abnormalities, or encephalopathy. Diuresis can be accomplished in these critically ill patients without serious complications that can be attributed to the diuretic treatment.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Alcoholism / complications*
  • Ascites / drug therapy*
  • Ascites / etiology
  • Ascites / mortality
  • Blood Urea Nitrogen
  • California
  • Creatinine / blood
  • Diuresis
  • Diuretics / adverse effects
  • Diuretics / therapeutic use*
  • Female
  • Hepatic Encephalopathy / etiology
  • Humans
  • Kidney Diseases / etiology
  • Liver Diseases / complications
  • Liver Diseases / drug therapy
  • Liver Diseases / etiology
  • Male
  • Middle Aged
  • Patient Compliance
  • Potassium / blood
  • Salts / metabolism
  • Sodium / blood
  • Uremia / complications
  • Water / metabolism
  • Water-Electrolyte Imbalance / chemically induced

Substances

  • Diuretics
  • Salts
  • Water
  • Sodium
  • Creatinine
  • Potassium