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March 7, 1977

An Optimal Diuretic Regimen for Cirrhotic AscitesA Controlled Trial Evaluating Safety and Efficacy of Spironolactone and Furosemide

JAMA. 1977;237(10):972-975. doi:10.1001/jama.1977.03270370044020

Previous studies demonstrated the effectiveness of diuretics in mobilizing fluid, but frequent complications occur with their use in treating ascites. To develop an effective but safe regimen for treatment of cirrhotic ascites, a two-part crossover study was done. Subjects with life-threatening complications of cirrhosis were excluded. In part one it was demonstrated that a sixday diuretic regimen with dietary sodium restriction of 10 mEq/day is safe and more effective than sodium restriction alone. In part two the duration of diuretic therapy was safely extended from six to nine days with mobilization of significantly more fluid. Careful selection of subjects, use of diuretics in modest dosages for brief periods of time, and daily monitoring of subjects were important for the success of this study.

(JAMA 237:972-975, 1977)