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      Circulación hiperdinámica de pacientes cirróticos: expresión renal de los efectos del propranolol Translated title: HYPERDYNAMIC CIRCULATION IN CIRRHOTIC PATIENTS: RENAL EXPRESSION OF EFFECTS OF PROPRANOLOL

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          Abstract

          Introducción: A fin de investigar los daños potenciales sobre el funcionalismo renal que pueden causar los medicamentos beta bloqueantes no selectivos (BBNS) en cirróticos con descompensación extrema de su equilibrio hemodinámico se evaluaron sus efectos administrándolos a enfermos con cirrosis y ascitis, con diferente grado de descompensación. Métodos: Se estudiaron dos fases: pre y post administración de propranolol, midiendo presión arterial media (PAM), y analítica sanguínea y urinaria, en 20 pacientes: diez con ascitis compensada y diez con ascitis más Peritonitis Bacteriana Espontánea (PBE), y un grupo control de diez individuos sin enfermedad hepática. Resultados: La concentración de sodio urinario/día obtuvo diferencia significativa (p<0.04) entre los pacientes y controles sin tratamiento, así como la Tasa de Reabsorción de sodio (p<0.04) entre pacientes compensados y pacientes con PBE previo al tratamiento. También se obtuvo diferencia significativa en los pacientes sin PBE antes y después del tratamiento, pero no se manifestó en el grupo con PBE al evaluar las dos fases, aunque la excreción del sodio si mostró tendencia a la disminución. La disminución de la Presión Arterial Media (PAM) considerada factor pronóstico de severidad obtuvo correlación positiva con la excreción de sodio en el grupo de pacientes Child C con PBE post trata- miento. Conclusiones: Los pacientes con extenso grado de descompensación hepática y hemodinámica son susceptibles de deterioro renal y hemodinámico con el tratamiento de pro- pranolol.

          Translated abstract

          Introduction: To investigate the potential damage to the kidney function that can cause non-selective beta blocker drugs (BBNS) in cirrhotic patients with decompensated extreme hemodynamic balance its effects were evaluated by administering to patients with cirrhosis and ascites, with varying degrees of decompensation. Methods: We performed a prospective analysis of twenty patients, ten with cirrhosis and ascites and ten with spontaneous bacterial peritonitis. A control group of ten subjects was studied too. All groups underwent measurement of blood pressure, and blood and urine tests, pre and post treatment with propranolol. Results: Significant difference (p<0.04) was observed in urinary sodium between total patients without treatment and control group. The Rate of Sodium Reabsorption was significant between compensated patients and those with SBP, (p<0.04) before treatment. Patients without SBP pre and post treatment showed also, however, there was no significant difference between patients with SPB although there was a tendency to decrease sodium excretion. Low Mean arterial pressure, factor of poor prognosis in these patients showed positive correlation with low urinary sodium excretion in Child C patients with SBP post treatment. Conclusions: Patients with liver and extensive degree of hemodynamic decompensation are susceptible of renal impairment.

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                gen
                Gen
                Gen
                Sociedad Venezolana de Gastroentereología
                0016-3503
                December 2015
                : 69
                : 4
                : 115-124
                Article
                S0016-35032015000400003
                9e146cd9-4415-4702-898d-587ff1f330e3

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Venezuela

                Self URI (journal page): http://www.scielo.org.ve/scielo.php?script=sci_serial&pid=0016-3503&lng=en

                ascites,cirrhosis,hyperdynamic circulation,propranolol, sodium,cirrosis, ascitis,circulación hiperdinámica,propranolol,sodio

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