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An Optimal Diuretic Regimen for Cirrhotic AscitesA Controlled Trial Evaluating Safety and Efficacy of Spironolactone and Furosemide
Richard K. Fuller, MD;
Parvez B. Khambatta, MD;
Gebre C. Gobezie, MD
JAMA. 1977;237(10):972-975.
Abstract
Previous studies demonstrated the effectiveness of diuretics in mobilizing fluid, but frequent complications occur with their use in treating ascites. To develop an effective but safe regimen for treatment of cirrhotic ascites, a two-part crossover study was done. Subjects with life-threatening complications of cirrhosis were excluded. In part one it was demonstrated that a sixday diuretic regimen with dietary sodium restriction of 10 mEq/day is safe and more effective than sodium restriction alone. In part two the duration of diuretic therapy was safely extended from six to nine days with mobilization of significantly more fluid. Careful selection of subjects, use of diuretics in modest dosages for brief periods of time, and daily monitoring of subjects were important for the success of this study.
(JAMA 237:972-975, 1977)
Author Affiliations
From the Gastroenterology Section, Cleveland Veterans Administration Hospital (Dr Fuller), and the Departments of Medicine (Drs Khambatta and Gobezie) and Biometry (Dr Fuller), Case Western Reserve University School of Medicine, Cleveland, Ohio. Dr Khambatta is now with the Huron Road Hospital, Cleveland, and Dr Gobezie is with Barstow Community Hospital, Barstow, Calif.
Footnotes
Reprint requests to Cleveland Veterans Administration Hospital, 10701 East Blvd, Cleveland, OH 44106 (Dr Fuller).
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