Effect of a Diet with Unrestricted Sodium on Ascites in Patients with Hepatic Cirrhosis
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background/Aims: There has been debate on whether a sodium-restricted diet (SRD) should be used in cirrhotic patients with ascites in China in recent years. The purpose of this study was to compare the effect of sodium-restricted and unrestricted diets on plasma renin activity (PRA), renal blood flow (RBF) and ascites in patients with liver cirrhosis. Methods: Two hundred cirrhotic patients with ascites were randomly divided into two groups (98 cases in the sodium-unrestricted diet [SUD] group and 102 cases in the SRD group); 95 patients (96.94%) in the SUD group and 97 patients (95.1%) in the SRD group had post-hepatitis B cirrhosis. Results: Blood sodium and RBF were higher in SUD group than in SRD group (p<0.001), while PRA were significantly lower in SUD group than the SRD group 10 days after treatment (p<0.001). Renal impairment caused by low blood sodium was higher in SRD group than in SUD group (p<0.01). Ascites disappeared in higher proportion of patients in SUD group than in SRD group (p<0.001). Conclusions: SUD can increase the level of blood sodium and RBF, and be beneficial to diuresis and ascite reduction and disappearance.
Abstract
Background/Aims: There has been debate on whether a sodium-restricted diet (SRD) should be used in cirrhotic patients with ascites in China in recent years. The purpose of this study was to compare the effect of sodium-restricted and unrestricted diets on plasma renin activity (PRA), renal blood flow (RBF) and ascites in patients with liver cirrhosis. Methods: Two hundred cirrhotic patients with ascites were randomly divided into two groups (98 cases in the sodium-unrestricted diet [SUD] group and 102 cases in the SRD group); 95 patients (96.94%) in the SUD group and 97 patients (95.1%) in the SRD group had post-hepatitis B cirrhosis. Results: Blood sodium and RBF were higher in SUD group than in SRD group (p<0.001), while PRA were significantly lower in SUD group than the SRD group 10 days after treatment (p<0.001). Renal impairment caused by low blood sodium was higher in SRD group than in SUD group (p<0.01). Ascites disappeared in higher proportion of patients in SUD group than in SRD group (p<0.001). Conclusions: SUD can increase the level of blood sodium and RBF, and be beneficial to diuresis and ascite reduction and disappearance.
참고문헌 (21)
- Moore KP, "The management of ascites in cirrhosis: report on the consensus conference of the International Ascites Club", Hepatology, 38, pp.258~266 (2003)
- Runyon BA, "Management of adult patients with ascites due to cirrhosis", Hepatology, 39, pp.841~856 (2004)
- Zeng X, "My view of sodium restriction in the treatment of cirrhotic ascites", Chin J Dig, 27, pp.331~333 (2007)
- Gu XB, "Influence of diet with or without sodium restriction on renal flow and ascites subsidence of patients with cirrhosis", Chin J Dig, 28, pp.61~62 (2008)
- Gu XB, "Influence of Na supplement and limitation on blood PRA, AII, ALD and renal function in patients with liver cirrhosis", Zhonghua Gan Zang Bing Za Zhi, 12, pp.370~ (2004)
- Gu XB, "Influence of sodium supplement and restriction on subsidence of cirrhotic ascites", Chin J Infect Dis, 22, pp.129~130 (2004)
- Liu JJ, "Sodium restriction to correct cirrhotic ascites and application of hypertonic NaCl in ascites patients", Clin Focus, 15, pp.1141~1143 (2000)
- Wang XC, "Color Doppler study on hepatorenal syndrome and renal artery hemodynamics in non-compensation period of cirrhosis", J Clin Hepatobiliary Dis, 12, pp.212~213 (1996)
- Liang CX, "Color Doppler study on renal artery hemodynamics of normal adults", J Ultrasonic Med, 11, pp.103~104 (1995)
- Domenicali M, "A novel sodium overload test predicting ascites decompensation in rats with CCl4-induced cirrhosis", J Hepatol, 43, pp.92~97 (2005)
- Wong F, "The mechanism of improved sodium homeostasis of low-dose losartan in preascitic cirrhosis", Hepatology, 35, pp.1449~1458 (2002)
- Arroyo V, "Prognostic value of spontaneous hyponatremia in cirrhosis with ascites", Am J Dig Dis, 21, pp.249~256 (1976)
- Ginès P, "Aquaretic agents: a new potential treatment of dilutional hyponatremia in cirrhosis", J Hepatol, 24, pp.506~512 (1996)
- Sterns RH, "Severe symptomatic hyponatremia: treatment and outcome. A study of 64 cases", Ann Intern Med, 107, pp.656~664 (1987)
- Reynolds TB, "Advantages of treatment of ascites without sodium restriction and without complete removal of excess fluid", Gut, 19, pp.549~553 (1978)
- Gauthier A, "Salt or no salt in the treatment of cirrhotic ascites: a randomised study", Gut, 27, pp.705~709 (1986)
- Desai HG, "Salt restriction in ascites with cirrhosis of liver: will enhanced salt restriction increase longevity?", J Assoc Physicians India, 54, pp.504~ (2006)
- Qiu ZG, "Hyponatremia of cirrhotic ascites", J Clin Hepatobiliary Dis, 10, pp.165~166 (1994)
- Gu XB, "36 cases of acute low sodium syndrome complicated by cirrhotic ascites", J Sino-Jpn Friendsh Hosp, 14, pp.192~ (2000)
- Wong F, "New challenge of hepatorenal syndrome: prevention and treatment", Hepatology, 34, pp.1242~1251 (2001)
- Liu JJ, "Disadvantage of sodium restriction in the treatment of cirrhotic ascites and measures", New Med, 34, pp.123~ (2003)
