Effects of Captopril on cirrhotic patients with refractory ascites: a preliminary report

ABSTRACT

To determine the effect of Captopril on cirrhotic patients with refractory ascites. A prospective study of effect of Captopril on twelve patients with biopsy proven liver cirrhosis with refractory ascites over a period of two weeks. Setting: Medical Unit IV, Civil Hospital Karachi. Twelve patients, eight males and four females, between the ages of 23 to 59 years with biopsy proven liver cirrhosis and ascites not responding to intense diuretic therapy. All patients had serum albumin > 2.5 gm/dl. None of the patient had SBP or electrolyte imbalance. All patients were given 12.5 mg/day to 25 mg/day Captopril along with Spironolactone and Furosemide. Reduction of body weight and increase in 24 hours urine output after two weeks of Captopril therapy along with diuretics. After starting of Captopril at a dose of 12.5 mg/day and then increases to 25 mg/day after one week along with Spironolactone and Furosemide, the body weight reduced to 1.2 kg [mean] from the initial pre-treatment weight at the end of first week, and 2.3 kg at the end of second week. The 24 hours urine output increased from 1.4 L to 1.6 L and 1.8 L after the first and second weeks of treatment respectively, which is an increase of 0.4 L in 24 hours. The blood pressure and serum electrolytes showed no significant variation. There were no major adverse effects apart from a non-significant dry cough in six patients. Captopril along with diuretics has a beneficial effect on cirrhotic patients with refractory ascites