An optimal diuretic regimen for cirrhotic ascites. A controlled trial evaluating safety and efficacy of spironolactone and furosemide
R. K. Fuller, P. B. Khambatta and G. C. Gobezie
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 six-day 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.
