Abstract
Background & Aims: The sodium and water retention and renal vasoconstriction exhibited by patients with cirrhotic ascites are similar to the changes observed by stimulation of renal adenosine 1 receptors. The aim of this study was to investigate the effects of FK352 (an adenosine 1 antagonist) on renal and systemic hemodynamics and renal function in cirrhotic patients with ascites. Methods: p-Aminohippuric acid and inulin clearance, urine flow rate, sodium and potassium excretion, and free water clearance were measured for 2 hours before and after FK352 administration. Cardiac output, systemic vascular resistance, plasma angiotensin II level, plasma renin activity, and noradrenaline, adrenaline, and adenosine 3',5'-cyclic monophosphate (cAMP) levels were also measured before and after FK352. Results: Urine sodium excretion and urine flow rate increased after FK352 by a mean of 199.9% ± 43.0% ( P < 0.001) and 51.2% ± 17.5% ( P < 0.02), respectively. Plasma cAMP and angiotensin II levels and plasma renin activity also increased by 10.8% ± 3.2% ( P < 0.01), 36.9% ± 11.3% ( P < 0.01), and 247.9% ± 82.6% ( P < 0.02), respectively. No change was detected in any other parameter. Conclusions: The isokaliuretic improvement in natriuresis and diuresis suggests a role for adenosine 1 antagonism in the treatment of the renal abnormalities found in advanced cirrhosis. GASTROENTEROLOGY 1998;115:406-411
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