Abstract
Background: Ascites is the most common complication of liver cirrhosis and about 5-10% of all cases develop refractory ascites, 50% of such patients die within 6 months of its development. Aim of the Work: to assess the usefulness of adding midodrine beside the standard medical treatment for patients with liver cirrhosis and refractory ascites. Patients and Methods: This study included 78 patients with liver cirrhosis and refractory ascites or recurrent ascites, <i>Group A</i>: (n=37) patients on standard medical treatment (SMT) [low sodium diet + diuretic therapy (loop diuretic in a dose 40-160 mg/day and distal acting diuretic in a dose 100-400 mg/day + large volume paracentesis as needed] <i>Group B</i>: (n=41) patients with standard medical treatment (SMT) and midodrine tolerable dose. Results: Statistical significant difference between the SMT group and midodrine group as regard reduction in body weight and increase in mean arterial blood pressure and 24 h-urinary volume where P value was < 0.05. Conclusion, midodrine is a safe treatment for patients with liver cirrhosis and its addition to standard medical treatment is associated with better control of ascites.
Highlights
Ascites is the most common complication of cirrhosis
The patients were divided into 2 groups Group A: (n=45) patients on standard medical treatment [low sodium diet + diuretic therapy
Our study included 78 patients diagnosed to have liver cirrhosis and refractory ascites were admitted in gastroenterology unit and gastroenterology outpatients' clinic in internal medicine department, Assiut University
Summary
Ascites is the most common complication of cirrhosis. Once ascites develops, the prognosis worsens and the patient becomes susceptible to complications such as bacterial peritonitis, hepatic hydrothorax, hyponatraemia, and complications of diuretic therapy [1].Following the development of ascites, the patient’s quality of life declines significantly and survival is about 50% after 5 years of follow-up [2]. Once the ascites becomes refractory to medical therapy, the prognosis is worse, with only 40–60% of patients alive after 2 years without liver transplantation [3]. Splanchnic and systemic vasodilatation related to excess nitric oxide has been associated with systemic hypotension and increased portal flow. This is associated with hemodynamic compensatory mechanisms via activation of the renin-angiotensinaldosterone and sympathetic nervous systems and the nonosmotic release of antidiuretic hormones [4]. Aim of the Work: to assess the usefulness of adding midodrine beside the standard medical treatment for patients with liver cirrhosis and refractory ascites. Conclusion, midodrine is a safe treatment for patients with liver cirrhosis and its addition to standard medical treatment is associated with better control of ascites.
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call