Introduction Splanchnic arterial vasodilatation has related to hyperdynamic circulation and impaired natriuresis in advanced cirrhosis and was suggested to be responsible for the subtle sodium retention in pre-ascitic cirrhosis. α Adrenergic agonist may reverse this condition.

Aim This study aimed to evaluate the effects of treatment with the α1-adrenergic agonist midodrine on systemic haemodynamics in non-azotemic cirrhotic patients.

Method 154 cirrhotic patients were studied. The patients were classified into: absent ascites, mild to moderate diuretic responsive ascites and refractory ascites. Patients were randomly selected to receive either oral midodrine 10 mg, three times a day or placebo The following parameters were assessed for all patients: mean arterial pressure (MAP), cardiac output (CO), plasma rennin (Pl R) and renal resistive index (RRI) at baseline, 7 days after administration of oral midodrine 10 mg, three times daily, and 3 months after administration of oral midodrine 2.5 mg, three times a day.

Results Midodrine administration induced a significant increase in MAP mention levels and P and significant decreases in CO mention levels and P in patients without and with mild to moderate ascites but not in patients with refractory ascites. As well as significant decreases in Pl R activity mention levels and P and RRI in patients without and with mild to moderate ascites but not in patients with refractory ascites

Conclusion The administration of midodrine improves systemic haemodynamics associated with a suppression of the renin activity in cirrhotic patients without or with mild ascites. But had no effect in patients with refractory ascites