F. Steigmann, M.D., F.A.C.P.; A. Sison, M.D.
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Patients with cirrhosis of the liver occasionally have a "refractory" ascites that resists all therapeutic measures, including the "thiazide" diuretics. Therefore, repeated abdominal paracenteses, portosystemic shunts, bilateral adrenalectomies, or injections of human albumin or dialyzed autogenous ascitic fluid are performed; these give little help but have many reactions.
The finding of low sodium content in the urine, saliva, sweat, and feces of these patients, but with increased secretion of aldosterone, suggested the use of aldosterone antagonists for them. Spironolactone, 400 mg daily, plus one of the thiazide derivatives (300 mg hydrochlorothiazide, or 20 to 30 mg benzydroflumethiazide), proved to be
F. Steigmann, A. Sison. "Refractory" Ascites in Cirrhosis: Its Management by a Multiple Diuretic Approach.. Ann Intern Med. 1962;56:681. doi: 10.7326/0003-4819-56-4-681_2
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Published: Ann Intern Med. 1962;56(4):681.
Gastroenterology/Hepatology, Liver Disease.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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