SummaryCaptopril in association with furosemide was used to treat seven patients with intractable severe hypertension. All patients were unresponsive (dias tolic blood pressure higher than 105 mm Hg) to tritherapy (diuretic, betablocker, and vasodilator). An important fall in blood pressure was observed in all cases, and in four patients permitted a complete control of blood pressure, with only low doses (less than 300 mg/day) of the drug. This good effect was already present after one month of treatment, and persisted unchanged for as long as 18 to 26 months. Plasma renin activity increased and remained elevated after one year of treatment.Side effects were encountered in four patients: skin rashes in one, moderate taste disturbance in two, and one episode of orthostatic hypotension Which disappeared with furosemide withdrawal. None of these side effects caused the interruption of captopril. The careful follow-up of serum creatinine and creatinine clearance during one year of therapy in the seven patients confirms that a long-term blood pressure reduction by captopril in severe hypertensives with altered renal function may be obtained without further decrease of the glomerular filtration.

Letters1 September 1976Demeclocycline Treatment of Water Retention in CirrhosisANDRÉ DE TROYER, M.D., WILLY PILLOY, M.D., IVO BROECKAERT, M.D., JEAN-CLAUDE DEMANET, M.D., PH.D.ANDRÉ DE TROYER, M.D.Search for more papers by this author, WILLY PILLOY, M.D.Search for more papers by this author, IVO BROECKAERT, M.D.Search for more papers by this author, JEAN-CLAUDE DEMANET, M.D., PH.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-85-3-336 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe role of antidiuretic hormone (ADH) in the pathogenesis of fluid retention in cirrhosis of the liver remains unclear. The defect in water excretion in these patients probably represents defective formation of free water rather than its excessive reabsorption. Nevertheless recent measurement of plasma vasopressin levels with a highly sensitive radioimmunoassay revealed high or normal values in ascitic patients, even when hyponatremia was present (1). This suggests that ADH may be responsible, at least in part, for the abnormal water retention in patients with cirrhosis.We report here the first study of the effect in such patients of demeclocycline, a tetracycline...References1. PADFIELDMORTON PJ: Application of a sensitive radioimmunoassay for plasma arginine vasopressin to pathological conditions in man. Clin Sci 47:16P-17P, 1974 CrossrefGoogle Scholar2. SINGERROTENBERG ID: Demeclocycline-induced nephrogenic diabetes insipidus. In-vivo and in-vitro studies. Ann Intern Med 79:679-683, 1973 LinkGoogle Scholar3. DE TROYERDEMANET AJ: Correction of antidiuresis by demeclocycline. N Engl J Med 293:915-918, 1975 CrossrefMedlineGoogle Scholar4. WILSONPERRYSAMS DHW: Selective inhibition of human distal tubular function by demeclocycline. Curr Ther Res 15:734-740, 1973 Google Scholar5. SHILS M: Renal disease and metabolic effects of tetracycline. Ann Intern Med 58:389-408, 1963 LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Saint-Pierre Hospital rue Haute, 322 Brussels 1000, Belgium Jules Bordet Institute rue Heger-Bordet Brussels 1000, Belgium PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByTetracyclinesTolvaptan, an oral vasopressin antagonist, in the treatment of hyponatremia in cirrhosisEASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosisANTIBACTERIAL DRUGSHyponatremia in cirrhosis: clinical features and managementTetracyclinesHepatic encephalopathy and ascitesAquaretic agents: a new potential treatment of dilutional hyponatremia in cirrhosisVasopressin release and water metabolism in patients with cirrhosisAnesthesia for Liver TransplantationTreatment of ascites and renal failure in cirrhosisThe Pharmacologic Management of the Syndrome of Inappropriate Secretion of Antidiuretic HormoneRapid diuresis in patients with ascites from chronic liver disease: The importance of peripheral edemaDisorders of the Serum Electrolytes, Acid-Base Balance, and Renal Function in AlcoholismSerum electrolyte abnormalities caused by drugsImpaired Renal Water Excretion in Early Hepatic Cirrhosis: Lack of Relationship between Renal Water Excretion and Plasma Levels of Arginine Vasopressin, Angiotensin II, and Aldosterone after Water LoadingDerangements of renal water handling in liver diseaseDemoclocycline improves hyponatremia in chronic schizophrenicsDemeclocycline-Induced Natriuresis and Renal Insufficiency: In Vivo and In Vitro StudiesSyndrome of Inappropriate Antidiuretic Hormone SecretionDisturbed volume homeostasis in patients with cirrhosis of the liverClinical implications of research on the mechanism of action of lithiumPathogenesis of Sodium and Water Retention in Edematous DisordersHORMONES AND FLUID RETENTION IN CIRRHOSISRole of Vasopressin in Abnormal Water Excretion in Cirrhotic PatientsDANIEL BICHET, M.D., VICTORIA SZATALOWICZ, M.D., CIDIO CHAIMOVITZ, M.D., ROBERT W. SCHRIER, M.D.Tetracycline NephrotoxicityRole of vasopressin in impaired water excretion in conscious rats with experimental cirrhosisPenicillins, cephalosporins and tetracyclinesInappropriate antidiuretic hormone secretion of unknown originDemeclocycline therapy for resistant oedema in advanced cardiac failure.Endocrine Management after Pituitary SurgeryEffects of tetracyclines on aldosterone- and insulin-mediated Na+ transport in the toad urinary bladderDemeclocycline in the treatment of the syndrome of inappropriate antidiuretic hormone release: with measurement of plasma ADH.Superiority of Demeclocycline over Lithium in the Treatment of Chronic Syndrome of Inappropriate Secretion of Antidiuretic HormoneNew Treatments for HyponatremiaChronic demeclocycline therapy in the syndrome of inappropriate ADH secretion due to brain tumorRenal Failure Associated with Demeclocycline in CirrhosisFLAIR CARRILHO, M.B., JAUME BOSCH, M.D., VICENTE ARROYO, M.D., ANTONI MAS, M.B., JOSEP VIVER, M.B., JOAN RODES, M.D.Demeclocycline and Therapy of HyponatremiaMALCOLM COX, M.D., JOSEPH GUZZO, M.D., GAIL MORRISON, M.D., IRWIN SINGER, M.D.SAFETY OF LABORATORY WORKERSDEMECLOCYCLINE-INDUCED RENAL FAILURE 1 September 1976Volume 85, Issue 3Page: 336-336KeywordsAntidiuretic hormoneCirrhosisDemeclocyclineExcretionHyponatremiaLiverPathogenesisRadioimmunoassaysTetracyclinesVasopressin Issue Published: 1 September 1976 PDF DownloadLoading ...