A DOSE-RESPONSE STUDY OF ORALLY-ADMINISTERED TORSEMIDE IN PATIENTS WITH ASCITES DUE TO CIRRHOSIS

Background: This study evaluated the dose-response relationship of tor semide, the first pyridine-sulphonylurea loop diuretic, in patients wi th ascites due to cirrhosis. Methods: During a 13-day hospitalization period, 17 patients received single, oral doses of 5 mg, 10 mg, or 20 mg of torsemide or placebo in a randomized, double-blind, crossover fa shion. All the patients received a constant dose of spironolactone con comitantly beginning at least 7 days before the study. Electrolyte exc retion and urine volume were measured for 24 h after each dose. Body w eight was measured before, and 24 h after each dose. Results: Torsemid e was effective in producing statistically significant, dose-related i ncreases in urinary sodium and chloride excretion, with little effect on potassium or magnesium excretion. Urine volume increased and body w eight decreased in a dose-related manner. Conclusion: Torsemide increa sed sodium excretion substantially in patients with cirrhosis and asci tes who were receiving spironolactone.