Digestive Diseases and Sciences

, Volume 43, Issue 4, pp 893–897 | Cite as

Chronic Splanchnic Hemodynamic Effects of Spironolactone with Unrestricted Sodium Diet in Patients with Compensated Cirrhosis

  • Shigeo Sugano
  • Takashi Kawafune
  • Tugio Okajima
  • Kunihiko Ishii
  • Manabu Watanabe
  • Naoko Takamura


The purpose of this study is to determine thehemodynamic effects of spironolactone administrationassociated with an unrestricted sodium diet (salt 10 g)in patients with compensated cirrhosis and portal hypertension. We studied the hemodynamicchanges following eight weeks of administration ofeither placebo (N = 6) or spironolactone (100 mg/day) (N= 6 Pugh-Child's A and 6 B). No significant changes were observed after the administration of theplacebo. Spironolactone induced a significant reductionin the hepatic venous pressure gradient (HVPG)(–10.1 ± 13.3%, P < 0.05), which wasassociated with a significant reduction of cardiac output(–11.5 ± 9.3%, P < 0.01), plasma volume(–8.1 ± 4.7%, P< 0.01), and wedgedhepatic venous pressure (–10.5 ± 11.6%, P< 0.05). There was no significant change in hepatic blood flow and there was nosignificant correlation between the change in the HVPGand the change in circulating plasma volume. A decreasein the HVPG greater than 10% was observed in eight of 12 patients (67%), defined asresponders, at eight weeks. Six of six (100%) grade Apatients and two of six (33%) grade B patientsresponded. This study demonstrated that spironolactonewith an unrestricted sodium diet decreased the HVPG ingrade A patients but did not significantly decrease theHVPG in grade B patients.



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Copyright information

© Plenum Publishing Corporation 1998

Authors and Affiliations

  • Shigeo Sugano
  • Takashi Kawafune
  • Tugio Okajima
  • Kunihiko Ishii
  • Manabu Watanabe
  • Naoko Takamura

There are no affiliations available

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