POSTNEKROTIK SİROZLU HASTALARDA SOMATOSTATIN VE OCTREOTİD'İN BÖBREK FONKSİYONLARI ÜZERİNE ETKİLERİ

// was proposed that somatostatin and octreotide can drive the splanchic blood into general circulation by constricting the splanchnic vessels and may ameliorate impaired functions in cirrhotic patients by their inhibitory effects on vasoconstricting hormones and mediators. We investigated the effects of both drugs on the renal functions of the patients with postnecrotic cirrhosis. No patient had an additional systemic disease deteriorating renal functions. Octreotide (100 pg t.i.d) was administered subcutaneously for three consecutive days to 21 patients. To observe the immediate and late effects of the drug, measurements were performed immediately and two days after the last administration of the drug and compared with initial results. Three weeks later somatostatin (250 pg i.v. bolus) was administered to ten patients randomly chosen from the same patients. Same measurements with octreotide were performed before and immediately after the administration of this drug. The immediate responses to octreotide were increased daily urine output, urine sodium (Na), fractional excretion of sodium (FeNa) and decreased plasma aldosterone and antidiuretic hormone (ADH). Prolonged decrease in ADH was observed two days after cessation of the drug. Somatostatin increased urine Na, FeNa, plasma creatinine, plasma renin activity (PRA) and decreased urine creatinine, creatinine clear ence (Cer), plasma Na and glomerular filtration rate (GFR). Unsignificanfalls in daily urine output and aldosterone level were also observed. These results indicate that octreotide has no considerable adverse effects on the renal functions in the patients with postnecrotic cirrhosis and even may be beneficial by virtue of increasing daily urine output and urine Na excretion. Somatostatin should be used with caution in cirrhotic patients who have impaired renalfunctions.