In a randomized double-blind trial we compared the effects of
torasemide, a new
loop diuretic, and
furosemide in nonazotemic cirrhotic patients with
ascites during a 3-day period in association with
potassium canrenoate (200 mg/day) administration. Doses of
loop diuretics administered in this trial (10 and 25 mg/day of
torasemide and
furosemide, respectively) had been shown to be equipotent in healthy subjects.
Torasemide induced significantly greater natriuresis than
furosemide (p less than 0.02), with a twofold greater percentage increase in basal values (day 1: 130% vs. 50%; day 2: 104% vs. 42%; and day 3: 65% vs. 26%, respectively).
Body weight loss was significantly higher during
torasemide (p less than 0.02) administration, and the overall decrease at the end of the treatment was twice as high for
furosemide (2.5 +/- 0.6 kg vs. 1.3 +/- 0.4 kg, respectively). Diuresis was also higher during
torasemide administration, but the difference was not significant (p = 0.08). The extent of kaliuresis observed during the two treatments was almost identical despite the striking differences in the natriuretic response. The effects of the two treatments on plasma
electrolytes,
creatinine clearance, blood
urea nitrogen, mean arterial pressure, heart rate and plasma
arginine vasopressin concentration were similar. Both drugs caused increases in plasma
renin activity at the end of the treatment, whereas plasma
aldosterone concentration slightly increased only after
torasemide administration. Despite the presence of a trend toward a more pronounced effect on these parameters after
torasemide administration, no significant difference between the two treatments was observed.(ABSTRACT TRUNCATED AT 250 WORDS)