Abstract
Etilefrine Could Improve Response to Standard Medical Therapy in Chronic Hepatitis C Egyptian Patients with Cirrhotic Refractory Ascites: A Randomized Pilot Study
Highlights
Ascites is a frequent complication of cirrhosis that accounts for over 75% of episodes of ascites
These results suggest that the addition of etilefrine to standard medical treatment (SMT) improves the systemic hemo dynamics and enhances water and sodium excretion, providing better control in patients with refractory cirrhotic ascites treated with SMT alone
Splanchnic arterial vasodilatation induced by nitric oxide [32] and glucagons [33] leads to disturbance of systemic hemodynamics reflected as reduced arterial blood pressure, reduced vascular resistance, and decreased effective blood volume with activation of potent vasoconstricting systems such as the sympathetic nervous system, the rennin angiotensin aldosterone system, in addition to nonosmotic release of vasopressin [34-36]
Summary
Ascites is a frequent complication of cirrhosis that accounts for over 75% of episodes of ascites. One of the most serious complications in cirrhotic patients with ascites is the occurrence of refractoriness that is the inability to resolve ascites by the standard medical treatment. The aim of this study is to evaluate the effects of etilefrine on systemic hemo dynamics, renal function and control of ascites in chronic hepatitis C (CHC) patients with cirrhotic refractory ascites receiving standard medical treatment (SMT) with low sodium diet and maximal diuretic doses of 160mg/day of furosemide and 400 mg/day of spironolactone. Many patients are referred for liver transplantation after development of ascites. The available therapies for patients with refractory ascites are repeated large volume paracentesis, transjugular intra hepatic portosystemic shunts, peritoneovenous shunts, and liver transplantation [5,6].
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