Effects of chronic octreotide treatment on renal function in cirrhotic patients: a randomised, double-blind, controlled trial

Ottesen, Lone H.; Aagaard, Niels Kristian; Kiszka-Kanowitz, Marianne; Rehling, Michael; Henriksen, J.H.; Eb, Pedersen; Flyvbjerg, Allan; Bendtsen, Flemming

doi:10.1016/s0168-8278(01)80929-6

Cited by 2 publications

(3 citation statements)

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“…Despite the dramatic hemodynamic effects of terlipressin, central and arterial blood volume increases only slightly after terlipressin administration and the effect on central hypovolemia is only modest [95,101]. In smaller studies, the combination of intravenously administered albumin and other vasoconstrictors such as ornipressin, noradrenaline, dopamine, somatostatin, and octreotide have been shown to increase GFR and normalize RAAS and SNS activity, although their effects are less potent [105][106][107][108]. However, when combined with the a-adrenergic agonist midodrine, octreotide may have a short-term effect on RBF, GFR, and sodium excretion in a few patients with HRS [95,109].…”

Section: Correction Of Circulatory Dysfunctionmentioning

confidence: 99%

Pathogenetic background for treatment of ascites and hepatorenal syndrome

2008

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Ascites and hepatorenal syndrome (HRS) are the major and challenging complications of cirrhosis and portal hypertension that significantly affect the course of the disease. Liver insufficiency, portal hypertension, arterial vasodilatation, and systemic cardiovascular dysfunction are major pathophysiological hallmarks. Modern treatment of ascites is based on this recognition and includes modest salt restriction and stepwise diuretic therapy with spironolactone and loop diuretics. Tense and refractory ascites should be treated with a large volume paracentesis, followed by volume expansion or transjugular intrahepatic portosystemic shunt. New treatment strategies include the use of vasopressin V(2)-receptor antagonists and vasoconstrictors. The HRS denotes a functional and reversible impairment of renal function in patients with severe cirrhosis with a poor prognosis. Attempts of treatment should seek to improve liver function, ameliorate arterial hypotension and central hypovolemia, and reduce renal vasoconstriction. Ample treatment of ascites and HRS is important to improve the quality of life and prevent further complications, but since treatment of fluid retention does not significantly improve survival, these patients should always be considered for liver transplantation.

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Section: Correction Of Circulatory Dysfunctionmentioning

confidence: 99%

Pathogenetic background for treatment of ascites and hepatorenal syndrome

2008

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“…A number of studies in humans and experimental animal models have shown that treatment with the somatostatin analog octreotide reverses systemic vasodilatation in conditions with portal hypertension due to portal vein stenosis or cirrhotic liver disease (1,17,29,31,43,45). In agreement with this, we have previously shown that long-time treatment with octreotide in a 100-fold higher dose than used in the present study (19) prevented renal vasodilatation in cirrhotic rats without affecting mean arterial pressure in rats with CBL-induced liver cirrhosis.…”

Section: Discussionmentioning

confidence: 99%

“…octreotide-LAR; inner stripe of outer medulla; sodium retention; furosemide SOMATOSTATIN IS A 14-amino acid peptide that is present in the hypothalamus, the gastrointestinal tract, as well as in the kidneys (7). It serves as a paracrine inhibitor of growth hormone secretion from the hypothalamus and of the release of glucagon, insulin, and gastrin in the gastrointestinal tract (25,31,37). In addition to this, it has been shown that the longacting analog octreotide has the ability to reverse systemic vasodilatation and ameliorate renal sodium retention in rats with carbon tetrachloride-induced liver cirrhosis (39).…”

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Intrarenal octreotide treatment prevents sodium retention in liver cirrhotic rats: evidence for direct effects within the thick ascending limb of Henle's loop

Jonassen

Christensen²,

Marcussen³

et al. 2006

American Journal of Physiology-Renal Physiology

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We have previously shown that systemic treatment with the somatostatin analog octreotide has marked beneficial effects on renal function in rats with liver cirrhosis induced by common bile duct ligation (CBL; Jonassen TEN, Christensen S, Sørensen AM, Marcussen N, Flyvbjerg A, Andreasen F, and Petersen JS. Hepatology 29: 1387-1395, 1999). In the present study, we tested the hypothesis that octreotide has a direct effect on renal tubular function. Rats (CBL or Sham-CBL) were intrarenally treated with low-dose octreotide in a long-acting release formulation, which had no systemic actions (100 microg/kg body wt as a single dose). Rats receiving low-dose octreotide (sc) were used as controls. The rats were chronically instrumented, and renal function was examined 4 wk after CBL or Sham-CBL. Intrarenal octreotide administration (IROA) prevented sodium retention in CBL rats without changes in renal plasma flow, glomerular filtration rate, or circulating levels of aldosterone and vasopressin. Renal clearance studies revealed that IROA normalized the increased natriuretic efficacy of furosemide found in CBL rats. Furthermore, IROA protected against the development of hypertrophy of the inner stripe of the outer medulla and thereby the increased the volume of thick ascending limb of Henle's loop (TAL) epithelium found in CBL rats. Finally, Western blot analyses of outer medullary homogenates showed increased abundance of the furosemide-sensitive Na-K-2Cl (NKCC2) cotransporter. IROA did not affect the abundance of NCKK2 within the outer medulla. Together with the histological findings, these results indicate that IROA reduces the total number of NKCC2 within the outer medulla. In conclusion, the results indicate a direct intrarenal effect of octreotide on TAL function and morphology in cirrhotic rats.

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Effects of chronic octreotide treatment on renal function in cirrhotic patients: a randomised, double-blind, controlled trial

Cited by 2 publications

References 0 publications

Pathogenetic background for treatment of ascites and hepatorenal syndrome

Pathogenetic background for treatment of ascites and hepatorenal syndrome

Intrarenal octreotide treatment prevents sodium retention in liver cirrhotic rats: evidence for direct effects within the thick ascending limb of Henle's loop

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