Valeur pronostique du système rénine-angiotensine dans la réponse à la restriction sodée et le pronostic de l'ascite cirrhotique d'origine alcoolique [Prognostic value of the renin-angiotensin system in response to salt restriction and prognosis of alcoholic ascitic cirrhosis].

Détails

ID Serval
serval:BIB_2E44B52E8134
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Valeur pronostique du système rénine-angiotensine dans la réponse à la restriction sodée et le pronostic de l'ascite cirrhotique d'origine alcoolique [Prognostic value of the renin-angiotensin system in response to salt restriction and prognosis of alcoholic ascitic cirrhosis].
Périodique
Schweizerische Medizinische Wochenschrift
Auteur(s)
Genoud E., Gonvers J.J., Schaller M.D., Essinger A., Haller E., Brunner H.R.
ISSN
0036-7672 (Print)
ISSN-L
0036-7672
Statut éditorial
Publié
Date de publication
1986
Volume
116
Numéro
15
Pages
463-469
Langue
français
Résumé
Prognostic factors in alcoholic cirrhosis with ascites were analyzed in a prospective study of 37 patients (25 men, 12 women), 26 of whom presented with clinically diagnosed ascites. A good therapeutic response following salt restriction was obtained in 50%; this response correlated well with an initially small ascites volume, male sex, daily urinary sodium excretion of greater than 10 mmol, plasma renin activity of less than 5 ng/ml/hr and a normal plasma aldosterone level. On the other hand, age, number of episodes and duration of ascites, hepatic functional parameters, plasma creatinine concentration and portal venous pressure had no predictive value as to therapeutic response. Patients' survival was inversely related to plasma renin activity and positively to sodium excretion. The one-year mortality rate reached 88% in patients with renin of greater than 5 ng/ml/hr or daily urinary sodium excretion of less than 10 mmol, while 70% of patients with renin of less than 5 ng/ml/hr or daily sodium excretion of greater than 10 mmol survived more than two years. No prognostic index of survival could be derived from age, sex, number of episodes, duration and volume of ascites, portal venous pressure or hepatic biochemical parameters. Thus, in cirrhotic alcoholic patients with ascites the determination of daily urinary sodium excretion, which is inversely related to the activity of the renin-angiotensin system, provides a useful prognostic index for the response to salt restriction and longterm survival.
Mots-clé
Adult, Aged, Angiotensin II/blood, Blood Chemical Analysis, Body Weight, Diet, Sodium-Restricted, Female, Humans, Liver Cirrhosis, Alcoholic/blood, Liver Cirrhosis, Alcoholic/drug therapy, Male, Middle Aged, Natriuresis, Peritoneovenous Shunt, Prognosis, Renin/blood
Pubmed
Création de la notice
06/09/2011 17:28
Dernière modification de la notice
20/08/2019 13:12
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