Assessment of the Response to an Experimental Dose of Furosemide in Patients with Decompensated Chronic Liver Disease and Ascites

Document Type : Original Article

Authors

1 Internal Medicine Department, Faculty of Medicine, Suez Canal University, Egypt

2 Endemic & Infectious Diseases Department, Faculty of Medicine, Suez Canal University, Egypt

3 Radiology Department, Faculty of Medicine, Suez Canal University, Egypt

Abstract

Background: Ascites due to cirrhosis can be mobilized with a treatment regimen consisting of dietary sodium restriction and oral diuretics. Ascites resistant to diuretic therapy requests adopting balanced approaches in its management but treatment responses are variable and frequently difficult to assess. Aim: To quantify response to an experimental dose of furosemide in patients with decompensated chronic liver disease and ascites. Subjects and Methods: a pre-post intervention study was carried out on 110 patients with ascites grade 2 or 3 receiving IV furosemide, and response was assessed by Absolute and percentage weight loss, the average daily weight loss, average daily urine output and % deviation from the pre-intervention 24-h output, 24h urinary sodium, and fractional excretion of sodium. Results: our study revealed that 42.7% were responders to furosemide, and presence of moderate positive significant correlation between average daily urine output and average daily weight reduction (r = 0.682), also there is significant relationship between baseline urinary sodium level and FENa and diuretic response. Conclusion: This study revealed that the median point for diuretic response using absolute weight loss is around -0.4kg and average daily urine output around 1500ml, and that there is significant correlation between 24h urinary sodium and diuretic response.

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