Efectos de la infusión aguda de octreotido sobre la función renal en pacientes con cirrosis hepática e hipertensión portal

Background: Octreotide is used in the treatment of acute variceal bleeding, based on its inhibitory effects of post-prandial splanchnic hyperemia and splanchnic venoconstriction. The consequences of these haemodynamic changes on renal circulation are not well known in cirrhotic patients. Aim: To eva...

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Autores principales:	Silva P,Guillermo, Segovia M,Roberto, Backhouse E,Claudia, Palma,Mariana, Márquez,Sylvia, Iturriaga R,Hernán
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2004
Materias:	Hypertension, portal Liver, cirrhosis Octreotide Portal pressure
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872004000200002
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spelling	oai:scielo:S0034-988720040002000022005-11-23Efectos de la infusión aguda de octreotido sobre la función renal en pacientes con cirrosis hepática e hipertensión portalSilva P,GuillermoSegovia M,RobertoBackhouse E,ClaudiaPalma,MarianaMárquez,SylviaIturriaga R,Hernán Hypertension, portal Liver, cirrhosis Octreotide Portal pressure Background: Octreotide is used in the treatment of acute variceal bleeding, based on its inhibitory effects of post-prandial splanchnic hyperemia and splanchnic venoconstriction. The consequences of these haemodynamic changes on renal circulation are not well known in cirrhotic patients. Aim: To evaluate the effects of acute octreotide administration on several parameters of renal function, including free water clearance, in patients with cirrhosis with or without ascites. Patients and Methods: Twenty cirrhotic patients, Child-Pugh A or B, with or without ascites, with esophageal varices, normal renal function and free of medications (vasoactive drugs or diuretics) were assigned to 2 different protocols. Protocol 1: 10 patients were randomized to receive octreotide or placebo, as a bolus followed by a continuous infusion. Glomerular filtration rate (GFR) and renal plasma flow (PRF) were measured, in basal conditions and during the drug or placebo administration. Protocol 2: 10 additional patients were randomized in the same way and free water clearance and urinary sodium excretion were again measured in the basal period and during the drug or placebo infusion. Results: After octreotide or placebo administration no significant changes were observed neither in GFR nor in PRF. The free water clearance decreased significantly during octreotide administration (3.12 ml/min±1.04 SE vs 0.88±0.39, p <.03). In both protocols no changes in mean arterial pressure were observed. Conclusions: Acute administration of octreotide to cirrhotic patients with portal hypertension, with or without ascites, did not produce any change in glomerular filtration rate or in estimated renal plasma blood flow. However the free water clearance decreased significantly. This effect, under chronic administration, could be clinically important and deserves further studies (Rev Méd Chile 2004; 132: 144-50)info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.132 n.2 20042004-02-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872004000200002es10.4067/S0034-98872004000200002
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Hypertension, portal Liver, cirrhosis Octreotide Portal pressure
spellingShingle	Hypertension, portal Liver, cirrhosis Octreotide Portal pressure Silva P,Guillermo Segovia M,Roberto Backhouse E,Claudia Palma,Mariana Márquez,Sylvia Iturriaga R,Hernán Efectos de la infusión aguda de octreotido sobre la función renal en pacientes con cirrosis hepática e hipertensión portal
description	Background: Octreotide is used in the treatment of acute variceal bleeding, based on its inhibitory effects of post-prandial splanchnic hyperemia and splanchnic venoconstriction. The consequences of these haemodynamic changes on renal circulation are not well known in cirrhotic patients. Aim: To evaluate the effects of acute octreotide administration on several parameters of renal function, including free water clearance, in patients with cirrhosis with or without ascites. Patients and Methods: Twenty cirrhotic patients, Child-Pugh A or B, with or without ascites, with esophageal varices, normal renal function and free of medications (vasoactive drugs or diuretics) were assigned to 2 different protocols. Protocol 1: 10 patients were randomized to receive octreotide or placebo, as a bolus followed by a continuous infusion. Glomerular filtration rate (GFR) and renal plasma flow (PRF) were measured, in basal conditions and during the drug or placebo administration. Protocol 2: 10 additional patients were randomized in the same way and free water clearance and urinary sodium excretion were again measured in the basal period and during the drug or placebo infusion. Results: After octreotide or placebo administration no significant changes were observed neither in GFR nor in PRF. The free water clearance decreased significantly during octreotide administration (3.12 ml/min±1.04 SE vs 0.88±0.39, p <.03). In both protocols no changes in mean arterial pressure were observed. Conclusions: Acute administration of octreotide to cirrhotic patients with portal hypertension, with or without ascites, did not produce any change in glomerular filtration rate or in estimated renal plasma blood flow. However the free water clearance decreased significantly. This effect, under chronic administration, could be clinically important and deserves further studies (Rev Méd Chile 2004; 132: 144-50)
author	Silva P,Guillermo Segovia M,Roberto Backhouse E,Claudia Palma,Mariana Márquez,Sylvia Iturriaga R,Hernán
author_facet	Silva P,Guillermo Segovia M,Roberto Backhouse E,Claudia Palma,Mariana Márquez,Sylvia Iturriaga R,Hernán
author_sort	Silva P,Guillermo
title	Efectos de la infusión aguda de octreotido sobre la función renal en pacientes con cirrosis hepática e hipertensión portal
title_short	Efectos de la infusión aguda de octreotido sobre la función renal en pacientes con cirrosis hepática e hipertensión portal
title_full	Efectos de la infusión aguda de octreotido sobre la función renal en pacientes con cirrosis hepática e hipertensión portal
title_fullStr	Efectos de la infusión aguda de octreotido sobre la función renal en pacientes con cirrosis hepática e hipertensión portal
title_full_unstemmed	Efectos de la infusión aguda de octreotido sobre la función renal en pacientes con cirrosis hepática e hipertensión portal
title_sort	efectos de la infusión aguda de octreotido sobre la función renal en pacientes con cirrosis hepática e hipertensión portal
publisher	Sociedad Médica de Santiago
publishDate	2004
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872004000200002
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Efectos de la infusión aguda de octreotido sobre la función renal en pacientes con cirrosis hepática e hipertensión portal

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