The Effects of Clonidine on the Diuretic Response in Cirrhotic Patients

The Effects of Clonidine on the Diuretic Response in Cirrhotic Patients With Ascites and Activation of Sympathetic Nervous System: a Randomized Double-Blind Placebo Controlled Study.

To examine the effects of the addition of clonidine to diuretics on the mobilization of ascites at short-term (diuretic response and requirement of diuretics) and long-term (readmissions for tense ascites and requirement of diuretics) in cirrhotics with increased sympathetic nervous system. Secondary objectives were to study neuro-hormonal,hemodynamic effects and side effects of clonidine and diuretics.

Inclusion Criteria:

• Cirrhotic patients with ascites
• Plasma norepinephrine level > 300 pg/mL (normal value: 185 - 275 pg/mL)

Exclusion Criteria:

• Serum bilirubin concentration above 4.5 mg/dL
• Prothrombin time below 40%
• Platelet count below 40 X 10¨9/liter
• Serum creatinine concentration above 2 mg/dL
• Gastro-intestinal hemorrhage
• Alcoholic hepatitis
• Diabetes mellitus,
• Hepatocellular carcinoma
• Respiratory or cardiac failures
• Hepatic encephalopathy
• Bacterial infection