| Midodrine In Patients With Cirrhosis And Refractory Or Recurrent Ascites: A Randomized Pilot Study. | |
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MedLine Citation:
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PMID: 21749847 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND / AIMS: Splanchnic arterial vasodilatation plays an important role in cirrhotic ascites. The aim of this study was to evaluate the effects of long term administration of midodrine on systemic hemodynamics, renal function and control of ascites in patients with cirrhosis and refractory or recurrent ascites. METHODS: Forty cirrhotic patients with refractory or recurrent ascites were prospectively studied after long term administration of midodrine plus standard medical therapy (n=20) or standard medical therapy alone (n=20) in a randomized controlled trial at a tertiary center. RESULTS: A significant increase in urinary volume, urinary sodium excretion, mean arterial pressure and decrease in plasma renin activity (p<0.05) was noted after one month of midodrine administration. There was also a significant decrease in cardiac output and an increase in systemic vascular resistance after midodrine therapy at 3 months (p<0.05). There was no change in glomerular filtration rate and model for end-stage liver disease (MELD) score. Midodrine plus standard medical therapy was significantly superior to standard medical therapy alone in the control of ascites (p=0.013) at three months. The mortality rate in the standard medical therapy group was significantly higher than the midodrine group (p<0.046). There wasno significant difference in the frequency of various complications at the end of follow-up. CONCLUSIONS: The results of this randomized pilot study suggest that midodrine plus standard medical therapy improves the systemic hemodynamics without any renal or hepatic dysfunction in these patients and is superior to standard medical therapy alone for the control of ascitis. |
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Authors:
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Virendra Singh; Sahdeb P Dhungana; Baljinder Singh; Rajesh Vijayverghia; Chander K Nain; Navneet Sharma; Ashish Bhalla; Pramod K Gupta |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-7-9 |
Journal Detail:
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Title: Journal of hepatology Volume: - ISSN: 0168-8278 ISO Abbreviation: - Publication Date: 2011 Jul |
Date Detail:
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Created Date: 2011-7-13 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8503886 Medline TA: J Hepatol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011. Published by Elsevier B.V. |
Affiliation:
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Department of Hepatology, Postgraduate Institute of Medical Education & Research, Chandigarh (India). |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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