Background/Aims: In patients with liver cirrhosis and ascites, the renin an
giotensin system is usually activated. Such a correlation supports the hypo
thesis that activation of the renin-angiotensin system plays an influential
role in the pathogenesis of ascites in liver cirrhosis.
Methodology: In this study, 25 patients with liver cirrhosis and ascites (1
0 females, 15 males; age: 45-67 years) were enrolled. We evaluated the acut
e effects of converting enzyme inhibitor (a single dose of 50mg captopril t
aken orally) on glomerular filtration rate, effective renal plasma flow, fi
ltration fraction, plasma renin activity, and plasma aldosterone.
Results: Oral intake of a single 50mg dose of captopril significantly decre
ased glomerular filtration rate (65+/-6mL/min/1.73m(2) vs. 53+/-9mL/min/1.7
3m(2)), filtration fraction (21.2+/-2.7% vs. 15.5+/-4.1%), and plasma aldos
terone (340+/-80pg/mL vs. 247+/-42pg/mL), but increased plasma renin activi
ty (2.65+/-2.19ng/mL/hr vs. 11.58+/-2.70ng/mL/hr) and effective renal plasm
a flow (312+/-41mL/min/1.73 vs. 356+/-60mL/min/1.73m(2)).
Conclusions: We suggest that oral intake of a single dose of 50mg captopril
can block the renin-angiotension system, and result in changes in renal he
modynamics and function in cirrhotic patients with ascites.