Diagnostic usefulness of the random urine Na/K ratio in predicting therapeutic response for diuretics in cirrhotic patients with ascites

Basel, Mohamed El; Mazny, Ahmed El; Emam, Ahmed; Shehaby, Amal El

doi:10.4103/2356-8097.162394

Cited by 2 publications

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“…Patients with ascites usually require 24-h urine collection to evaluate urinary sodium secretion. The sodium-to-potassium ratio was considered a replacement for the collection of 24-h urine samples because the correlation between 24-h sodium and urinary sodium-to-potassium ratio concentration was significant and showed 75% sensitivity and 91.67% specificity [ 35 ]. The urinary sodium-to-potassium ratio is also a translatable quantitative biomarker of mineralocorticoid receptor antagonism and is used to determine the potential value of spironolactone [ 36 ].…”

Section: Methodsmentioning

confidence: 99%

Preclinical study of simultaneous pharmacokinetic and pharmacodynamic herb-drug interactions between Yin-Chen-Hao-Tang and spironolactone

Hsueh

Tsai²

2020

BMC Complement Med Ther

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Background: The prevalence and therapeutic effects of the use of herbal remedies for chronic liver diseases make the combined administration of herbal products with conventional treatment unable to be ignored. This study investigated the pharmacokinetic and pharmacodynamic herb-drug interactions between the herbal formula Yin-Chen-Hao-Tang (YCHT) and spironolactone. Methods: A selective high-performance liquid chromatography (HPLC) method was developed and validated for the detection of spironolactone and its metabolite canrenone in rat urine. The interaction study was conducted by collecting urine samples after oral administration of spironolactone alone or in combination with YCHT for 5 days. Urine pharmacokinetic parameters and urinary sodium, potassium, volume, and weight were analyzed. Results: The results revealed significant increases in the cumulative amount and the area under the rate curve (AURC) of the metabolite canrenone after pretreatment with the high dose of YCHT. The urine weight and volume were significantly reduced dose-dependently as a result of pretreatment with YCHT. The urinary sodium-topotassium ratio, which indicates diuretic effects, was also reduced in the high-dose YCHT condition. Conclusions: Herb-drug pharmacokinetic and pharmacodynamic interactions between YCHT and spironolactone were observed in the study. The herb-drug interaction that appeared with a single dose of spironolactone should be considered when patients are being treated with a continuous administration of this drug.

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Section: Methodsmentioning

confidence: 99%

Preclinical study of simultaneous pharmacokinetic and pharmacodynamic herb-drug interactions between Yin-Chen-Hao-Tang and spironolactone

Hsueh

Tsai²

2020

BMC Complement Med Ther

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“…In his study, EL Basel et al [17] tested the correlation between spot urinary Na/k ratio and 24-h urinary sodium. They found a significant correlation between the two with sensitivity 75% and specificity 91.6%.…”

Section: Discussionmentioning

confidence: 99%

Serum chloride and serum sodium derangements in children on prolonged furosemide therapy and their effect on diuretic response

Soliman

Kotby

Shabaan

et al. 2022

Egypt Pediatric Association Gaz

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Background Electrolyte disturbances are not uncommon in patients on chronic furosemide therapy. We hypothesized that serum chloride (Cl) and serum sodium (Na) abnormalities may occur in children on prolonged furosemide therapy affecting the diuretic response in these children. Methods The study included 45 children, with congenital left to right shunts causing chronic congestive state which necessitated chronic furosemide therapy. Patients in need to an increase of their furosemide dose were recruited in the study. We assessed serum Cl and serum Na as well as parameters of diuretic responsiveness; net fluid output and change in body weight/40 mg furosemide, and change in urinary Na/K ratio. These parameters were assessed initially and at day 3 after increasing furosemide dose. Results According to serum levels of Cl and Na, patients were divided into four groups: isolated hyponatremia (15 patients, 33.3%), isolated hypochloremia (9 patients, 20%), combined hypochloremia and hyponatremia (12 patients, 26.7%), and normal serum electrolytes (9 patients, 20%). Patients with combined hyponatremia and hypochloremia and those with isolated hypochloremia showed minimal clinical and radiological signs of decongestion as well as lowest changes in urinary Na/K ratio, fluid output and weight change/40 mg furosemide on augmenting the diuretic dose, unlike the hyponatremic patients who had near normal parameters with no evidence of diuretic resistance. Conclusion Both hypochloremia and hyponatremia are common in patients on prolonged furosemide therapy. Hypochloremia is associated with a poor diuretic response, unlike isolated hyponatremia which does not seem to affect the diuretic response. Concomitant occurrence of hyponatremia and hypochloremia is associated with poor diuretic response as well which can be worse than that seen in isolated hypochloremia.

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Diagnostic usefulness of the random urine Na/K ratio in predicting therapeutic response for diuretics in cirrhotic patients with ascites

Cited by 2 publications

References 0 publications

Preclinical study of simultaneous pharmacokinetic and pharmacodynamic herb-drug interactions between Yin-Chen-Hao-Tang and spironolactone

Preclinical study of simultaneous pharmacokinetic and pharmacodynamic herb-drug interactions between Yin-Chen-Hao-Tang and spironolactone

Serum chloride and serum sodium derangements in children on prolonged furosemide therapy and their effect on diuretic response

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