Evaluation of the relationship between post prandial concentration of venous ammonia with the usage of loop diuretic in cirrhosis patients

Abstract

In cirrhotic patients taking loop diuretics (mainly furosemide), blood ammonia levels increase. It is possible that there is a relationship between dose and frequency of furosemide and ammonia concentration. The importance of increasing ammonia concentration is its effect on the incidence and severity of hepatic encephalopathy in patients with cirrhosis. Aim: Evaluation of the relationship between post prandial concentration of venous ammonia with theusage of loop diuretic in cirrhosis patients. Methods:This case series study was performed on cirrhotic patients with Child Pugh C who were hospitalized in the internal wards of Sina Hospital. Demographic and clinical information of patients were recorded. Patients receiving furosemide were included in the study and venous blood samples were taken. After collection, blood samples were analyzed to measure ammonia concentration.Results:Based on the findings of this study and their statistical analysis, serum ammonia concentration in cirrhotic patients did not show a significant relationship with their age and sex. In comparison between the two groups of cirrhotic patients who received furosemide (test group) and the group that did not receive furosemide (control group), a significant difference (P value = 0.003) was observed between serum ammonia concentrations.Conclusion: This study was performed on child pugh-C class cirrhosis patients. As a result of this study, no correlation was found between ammonia concentration and male or female sex in cirrhotic patients, but these findings showed that post-prandial samples in cirrhotic patients who received oral furosemide. They were higher than cirrhotic patients who did not receive oral furosemide. It should also be noted that a direct relationship was observed between the dose of furosemide and serum ammonia concentration in cirrhotic patients.