Opinion Review
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 14, 2019; 25(26): 3283-3290
Published online Jul 14, 2019. doi: 10.3748/wjg.v25.i26.3283
Diuretic window hypothesis in cirrhosis: Changing the point of view
Anderson Brito-Azevedo
Anderson Brito-Azevedo, Liver Transplant Unit, São Lucas Hospital, Rio de Janeiro 22061-080, Brazil
Anderson Brito-Azevedo, Liver Transplant Unit, São Francisco na Providência de Deus Hospital, Rio de Janeiro 20520-053, Brazil
Anderson Brito-Azevedo, Liver Transplant Unit, Adventist Silvestre Hospital, Rio de Janeiro 22241-280, Brazil
Author contributions: Brito-Azevedo A designed, analyzed and wrote the paper.
Conflict-of-interest statement: The author declares that he does not have any conflict of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Anderson Brito-Azevedo, MD, MSc, Doctor, Liver Transplant Unit, Adventist Silvestre Hospital, 274 Ladeira do Ascurra st, Rio de Janeiro 22241-280, Brazil. andersonbrito.a@gmail.com
Telephone: +55-21-3034-3397
Received: February 3, 2019
Peer-review started: February 6, 2019
First decision: April 5, 2019
Revised: May 9, 2019
Accepted: May 31, 2019
Article in press: June 1, 2019
Published online: July 14, 2019
Core Tip

Core tip: The “window therapy hypothesis” for non-selective beta-blocker treatment was consolidated based on weak evidence. Nevertheless, it has helped to change clinical practice and the Baveno consensus about portal hypertension. In this opinion review, we detail the studies assembled to compose the hypothesis, demonstrating that another factor could be behind results and outcomes observed, the diuretic treatment factor. After careful analysis of the evidence, we suggest the “diuretic window hypothesis”.