COMPARATIVE-ANALYSIS OF TORASEMIDE AND FUROSEMIDE IN LIVER-CIRRHOSIS

This review concerns studies of the comparative efficacy and safety of torasemide and furosemide in patients with cirrhosis of the liver com plicated by ascites and oedema. The shortterm trials reviewed indicate d that in patients who had failed to respond with adequate diuresis an d loss of body weight and ascites to bed rest, restricted salt and wat er intake and spironolactone, torasemide had a longer duration of acti on than furosemide and resulted in a greater urinary excretion of salt and water and greater loss of body weight. Torascmide also had less e ffect than furosemide on urinary potassium excretion and unlike furose mide did not increase the fractional excretion of magnesium or phospha te or the blood ammonia concentration. Two longer term trials in simil ar patients with decompensated hepatic cirrhosis confirm the results o f the shorter term studies. These studies, albeit each in relatively s mall numbers of patients, confirm the ability of torasemide to enhance diuresis, free water clearance and fractional excretion of sodium and chloride, resulting in loss of body weight and mobilization of ascite s in patients with decompensated hepatic cirrhosis. In these patients, the relatively small increase in urinary excretion of potassium, indu ced by torasemide without any marked effect on renal function or on th e plasma neurohormonal profile, enhances its potential safety.