The effects of a single, intravenous dose of bumetanide versus furosemide in patients with ascites and edema due to alcoholic liver disease.

Ascites with or without edema, secondary to alcoholic liver disease, which had failed to respond to conventional in-hospital medical treatment with thiazides, spironolactone, and salt restriction was treated with a single intravenous dose of 0.5 mg bumetanide or 20 mg furosemide. In this single-blind, randomized, parallel study in 20 men over 18 years of age, significant diuresis and increased excretion of sodium, potassium, and chloride occurred with both drugs. Weight loss was slight but significant within groups but not between drug treatments. Osmolality was significantly decreased after both treatments due to the magnitude of urine volume. Sodium/potassium ratio was significantly increased up to 120 minutes after both treatments. Creatinine excretion and clearance were increased after treatment with bumetanide but not significantly. In the furosemide group, the increase was first significant but after 90 minutes remained decreased. Supine and standing blood pressure and pulse rate changes were negligible. EKG monitoring revealed no abnormalities. No consistent alterations of laboratory tests were identified after treatment, nor were any important clinical adverse responses recognized. A 15-decibel unilateral high-frequency hearing loss was observed following bumetanide treatment in one patient with prior evidence of ear disease.