Effects of long-term administration of octreotide on sodium retention and atrial natriuretic peptide in carbon tetrachloride-induced cirrhotic rats

Wang, Sun-Sang; Lee, Fa-Yauh; Wu, Shwu-Ling; Hwu, Chii‐Min; Chien, Chau‐Heng; Lee, Shou‐Dong; Tsai, Yang‐Te; Chao, Yee; Chen, Chun-Chia; Wang, Paulus S.

doi:10.1016/s0168-8278(97)80122-5

Cited by 17 publications

(15 citation statements)

References 33 publications

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“…10 In addition, the experimental studies indicate that an inhibitory effect of octreotide on renin-aldosterone secretion as well as normalization of arginin-vasopressin may be responsible for the beneficial effects on sodium excretion. 22,35,36 The results of these experimental studies could only be reproduced in a clinical setting in the part of increased mean arterial pressure, although serum concentrations of octreotide were clearly within the therapeutic range of 1,000 to 3,000 ng/L in the study period. 13,39 Interestingly, a beneficial effect of octreotide in conjunction with midodrine (an ␣-adrenergic agonist) on ERPF and urinary sodium excretion has lately been documented in cirrhotic patients with rapidly progressing hepatorenal syndrome.…”

Section: Discussionmentioning

confidence: 96%

Effects of a long-acting formulation of octreotide on renal function and renal sodium handling in cirrhotic patients with portal hypertension: A randomized, double-blind, controlled trial

et al. 2001

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Octreotide has been widely used for controlling acute variceal bleeding in cirrhotic patients. The exact mechanisms of the hemodynamic changes in response to octreotide are partly unknown, 1 and only a transient or no effect on hepatic venous pressure gradient (HVPG) has been demonstrated. [2][3][4][5][6] Lately, a marked increase of lower esophageal sphincter pressure has been described in response to intravenous octreotide in portal hypertensive patients in addition to a sustained suppression of postprandial splanchnic hyperemia. 3,7-9 These effects coincide with a reduction of plasma glucagon, 8,9 and this mechanism has been thought to be responsible for the suppression of splanchnic hyperemia. However,

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Section: Discussionmentioning

confidence: 96%

Effects of a long-acting formulation of octreotide on renal function and renal sodium handling in cirrhotic patients with portal hypertension: A randomized, double-blind, controlled trial

et al. 2001

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“…In portal hypertensive rats, this drug decreased plasma renin activity 27 ; in cirrhotic rats, it was shown that chronic octreotide treatment could inhibit sodium retention and prevent renal vasoconstriction without changes in glomerular filtration rate. 28,29 By contrast, in cirrhotic patients, somatostatin infusion induced renal vasoconstriction and impaired glomerular filtration rate, free water clearance, and sodium excretion. 30 Two others studies did not demonstrate any beneficial effects of octreotide on renal function in cirrhotic patients with or without ascites.…”

Section: Discussionmentioning

confidence: 99%

Octreotide in Hepatorenal Syndrome: A Randomized, Double–Blind, Placebo–Controlled, Crossover Study

Pomier‐Layrargues

2003

Hepatology

137

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The hepatorenal syndrome (HRS) is related to vasoconstriction of the renal cortex induced by systemic hypovolemia that follows splanchnic vasodilatation as the primary event in the cascade of hemodynamic changes associated with portal hypertension. We evaluated the effects of octreotide, a splanchnic vasoconstrictor, on HRS in cirrhotic patients. We compared the effects of octreotide infusion (50 g/h) to placebo using a randomized, doubleblind, cross-over design over 2, 4-day periods. Nineteen patients were included, and 14 patients could complete the 2 phases of the study (group 1: placebo first; n ‫؍‬ 8 and group 2: octreotide first; n ‫؍‬ 6) The end point of the study was to evaluate improvement in renal function as defined by a 20% decrease in serum creatinine value after a 4-day treatment as compared with baseline. In all the patients, a normal central venous pressure was maintained by daily intravenous administration of 2 units of albumin. The 2 groups were similar with regard to demographic data and liver and kidney function parameters at baseline. Improvement in renal function was observed in 2 patients after the placebo and 1 patient after octreotide infusion in group 1 and in 2 patients after octreotide infusion and 1 patient after placebo in group 2 (P ‫؍‬ not significant). In addition, treatment with octreotide infusion did not result in significant changes in creatinine clearance, daily urinary sodium, plasma renin activity, plasma aldosterone and glucagon levels, or renal and mesenteric artery resistance indices as measured by Doppler ultrasonography. In conclusion, the present study demonstrates that, under our experimental conditions, octreotide infusion combined with albumin is not effective for the treatment of HRS in cirrhotic patients. (HEPATOLOGY 2003;38:238-243.) T he hepatorenal syndrome (HRS) is a functional renal disorder associated with severe acute or chronic liver failure. It is always potentially reversible because no anatomic damage can be demonstrated in the kidney. This syndrome carries a very bad prognosis because it is always the consequence of severe liver insufficiency, the only definitive treatment being liver transplantation. 1 The pathophysiology of renal failure is thought to be mediated primarily by splanchnic vasodilatation leading to systemic hypovolemia; a cascade of vasoactive mechanisms is then initiated including compensatory activation of vasoconstrictor catecholamines, renin, aldosterone, antidiuretic hormone, and endothelin; a marked vasoconstriction of the renal cortex ensues, glomerular filtration decreases, and the kidney function deteriorates. 2 Over recent years, several attempts have been made to correct the cortical renal vasoconstriction by using splanchnic vasoconstrictors, in the hope of reversing splanchnic vasodilatation, which is thought to be the primary pathogenetic event. The efficacy of ornipressin, 3-5 terlipressin, 6-10 and octreotide alone 11 or combined with midodrine 12 has been tested in small uncontrolled pilot trials. Terlipressin appe...

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“…Sieber, et al 32) demonstrated that octreotide inhibited RAS activity and decreased aldosterone levels in healthy volunteers. Additionally, Wang, et al 33) showed that octreotide increased the elimination of sodium. Similarly, Jonassen, et al 34) showed that octreotide prevented sodium retention in patients with cirrhosis.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Octreotide in Dilated Cardiomyopathy: An Open-label Trial in 12 Patients

et al. 2004

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SUMMARYOctreotide, a somatostatin analogue, has been found effective in the treatment of acromegalic cardiomyopathy. We investigated whether intermittent octreotide therapy had beneficial effects in patients with ischemic or idiopathic dilated cardiomyopathy, which are refractory to conventional therapy.Twelve patients with ischemic or idiopathic dilated cardiomyopathy were enrolled in the study. In addition to conventional treatment, octreotide (first 50 µg and then 25 µg three times per day for 4 days) was administered and repeated after 1, 2, and 3 months. The patients were evaluated 3 times, before and immediately after the first treatment and after 3 months of treatment, using echocardiography, exercise stress testing, ambulatory ECG, right ventricular catheterization, cardiac enzymes, and the Minnesota living with heart failure questionnaire for quality of life.There were no significant changes in parameters after the first treatment. However, after 3 months of treatment, there were significant improvements in the left ventricular ejection fraction, left ventricular posterior wall thickness, hemodynamics, exercise capacity, and quality of life. Additionally, ischemic burden and the number of ventricular premature beats also decreased slightly.Intermittent octreotide therapy led to significant improvements in patients with ischemic and idiopathic dilated cardiomyopathy refractory to conventional treatment. We believe that this therapy should be attempted as an adjunctive therapy in these patients, and that in this respect, randomized, double-blind, clinical, and large-scale studies are required before regular usage is undertaken. (Jpn Heart J 2004; 45: 613-621)

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Effects of long-term administration of octreotide on sodium retention and atrial natriuretic peptide in carbon tetrachloride-induced cirrhotic rats

Cited by 17 publications

References 33 publications

Effects of a long-acting formulation of octreotide on renal function and renal sodium handling in cirrhotic patients with portal hypertension: A randomized, double-blind, controlled trial

Effects of a long-acting formulation of octreotide on renal function and renal sodium handling in cirrhotic patients with portal hypertension: A randomized, double-blind, controlled trial

Octreotide in Hepatorenal Syndrome: A Randomized, Double–Blind, Placebo–Controlled, Crossover Study

The Effects of Octreotide in Dilated Cardiomyopathy: An Open-label Trial in 12 Patients

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