The effect  of  1  month  of  therapy with midodrine, octreotide‐LAR and albumin in refractory ascites: a pilot study

Abstract

To our knowledge, this is the first study of prolonged midodrine, octreotide and albumin therapy in RA. We observed a significant reduction in the plasma renin and aldosterone concentrations and a trend towards a reduction in the volume of ascites removed by paracentesis without an effect on renal function. The beneficial effects are at the expense of a reversible deterioration in the MELD score. Large controlled trials are needed before this therapy can be routinely recommended.

Midodrine in patients with cirrhosis and refractory or recurrent ascites: A randomized pilot study

“…Recently, various vasoconstrictors have been used in nonazotemic cirrhotic patients with ascites and showed an improvement in circulatory and renal function and sodium excretion [19][20][21]. Midodrine, an oral a 1 -adrenergic agonist along with octreotide and albumin, has been shown to better control ascites in a short term pilot study in patients with refractory ascites [22]. There are no reports of long term use of midodrine in patients with cirrhosis and ascites.…”

Effect of Midodrine in Patients with Liver Cirrhosis and Refractory Ascites

“…That was not the situation with the pilot study done by. They recorded a significant deterioration in the MELD score during treatment with midodrine Tandon et al, 2009. [15].…”

“…There is also evidence that a similar reduction in fluid accumulation may occur with use of vasoconstrictors in patients with end-stage liver disease without a significant renal function improvement [15].…”

“…When combined, the studies by Villeneuve et al and Angeli et al suggest that diuretic resistance in cirrhotic patients with ascites is possibly due to diminished GFR, and orally administered midodrine could significantly improve GFR in nonazotemic cirrhotics with ascites [15].…”

“…Midodrine along with octerotide and albumin, has been shown to better control of ascites in a short term pilot study in patients with refractory ascites [15].…”