{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T10:52:11Z","timestamp":1792839131773,"version":"4.5.0"},"reference-count":21,"publisher":"BMJ","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[2010,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The aim of the study was to compare sequential versus combined diuretic therapy in patients with cirrhosis, moderate ascites and without renal failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>One hundred patients were randomly assigned to the two diuretic treatments. The sequential treatment provided potassium canrenoate at the initial dose of 200 mg\/day, then increased to 400 mg\/day. Non-responders were treated with 400 mg\/day of potassium canrenoate and furosemide at an initial dose of 50 mg\/day, then increased to 150 mg\/day. The combined treatment provided the initial dose of 200 mg\/day of potassium canrenoate and 50 mg\/day of furosemide, then increased to 400 mg\/day and 150 mg\/day, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Most patients who received sequential treatment responded to potassium canrenoate alone (19% to 200 mg\/day and 52.63% to 400 mg\/day, respectively). Most patients who received the combined treatment responded to the first two steps (40% to the first step and 50% to the second, ie, 400 mg\/day of potassium canrenoate plus 100 mg\/day of furosemide). Adverse effects (38% vs 20%, p&lt;0.05), in particular, hyperkalaemia (18% vs 4%, p&lt;0.05), were more frequent in patients who received sequential therapy. As a consequence, the per cent of patients who resolved ascites without changing the effective diuretic step was higher in those who received the combined treatment (56% vs 76%, p&lt;0.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The combined diuretic treatment is preferable to the sequential one in the treatment of moderate ascites in patients with cirrhosis and without renal failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>NCT00741663. This work is an open randomised clinical trial.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/gut.2008.176495","type":"journal-article","created":{"date-parts":[[2009,7,1]],"date-time":"2009-07-01T20:19:08Z","timestamp":1246479548000},"page":"98-104","source":"Crossref","is-referenced-by-count":122,"title":["Combined versus sequential diuretic treatment of ascites in non-azotaemic patients with cirrhosis: results of an open randomised clinical trial"],"prefix":"10.1136","volume":"59","author":[{"given":"P","family":"Angeli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Fasolato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Mazza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Okolicsanyi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Maresio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Velo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Galioto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Salinas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"D\u2019Aquino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Sticca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Gatta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2009,6,30]]},"reference":[{"key":"2025121221223795000_59.01.98.1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1040617"},{"key":"2025121221223795000_59.01.98.2","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1053\/jhep.2003.50315","article-title":"The management of ascites in cirrhosis: report on the consensus conference of the International Ascites Club.","volume":"38","author":"Moore","year":"2003","journal-title":"Hepatology"},{"key":"2025121221223795000_59.01.98.3","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510230122"},{"key":"2025121221223795000_59.01.98.4","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1016\/0016-5085(83)90198-1","article-title":"Randomized comparative study of efficacy of furosemide versus spironolactone in nonazotemic cirrhosis with ascites.","volume":"84","author":"Perez-Ayuso","year":"1983","journal-title":"Gastroenterology"},{"key":"2025121221223795000_59.01.98.5","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20066"},{"key":"2025121221223795000_59.01.98.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(03)00188-0"},{"key":"2025121221223795000_59.01.98.7","doi-asserted-by":"publisher","DOI":"10.1016\/0270-9139(91)91408-S"},{"key":"2025121221223795000_59.01.98.8","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1111\/j.1600-0676.1993.tb00624.x","article-title":"Efficacy and safety of the stepped care medical treatment of ascites in liver cirrhosis: a randomized controlled clinical trial comparing two diets with different sodium content.","volume":"13","author":"Bernardi","year":"1993","journal-title":"Liver Int"},{"key":"2025121221223795000_59.01.98.9","doi-asserted-by":"publisher","DOI":"10.1016\/0270-9139(94)90055-8"},{"key":"2025121221223795000_59.01.98.10","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510280407"},{"key":"2025121221223795000_59.01.98.11","first-page":"65","article-title":"Ecute effects of various diuretics on lithium clearance.","volume":"10","author":"Thomsen","year":"1987","journal-title":"Renal Physiol"},{"key":"2025121221223795000_59.01.98.12","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(99)80194-9"},{"key":"2025121221223795000_59.01.98.13","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(05)80217-X"},{"key":"2025121221223795000_59.01.98.14","doi-asserted-by":"crossref","unstructured":"Angeli P Gatta A . Medical treatment of ascites in cirrhosis. In: Gines P Arroyo V Rodes J Schrier RW , eds. Ascites and renal dysfunction in liver disease. Pathogenesis, diagnosis and treatment. 2nd edn. Malden, MA: Blackwell Publishing, 2005:227\u00e2\u0080\u009340.","DOI":"10.1002\/9780470987476.ch18"},{"key":"2025121221223795000_59.01.98.15","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/S0889-8553(21)00616-6","article-title":"Treatment of ascites in cirrhosis. 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Diuresis in the ascitic patient: a randomized controlled trial of three regimens. 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