2010 Aug;30(7):937-47. doi: 10.1111/j.1478-3231.2010.02272.x. EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis European Association for the Study of the Liver1 Ascites is the most common complication of cirrhosis, and 60% of patients with compensated cirrhosis develop ascites within 10 years during the course of their disease [1].
The decrease in portal hypertension results in a secondary decrease in the activation of RAAS, leading to an increased sodium excretion [Compared with repeated LVP, TIPS is considered a more effective treatment option for the control of ascites [However, the effect of TIPS on survival in patients with refractory ascites has not been clearly demonstrated. This site needs JavaScript to work properly.
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Large volume paracentesis and transjugular intrahepatic porto-systemic shunts are useful in managing patients with refractory ascites. 2017 Nov;14(5):5228-5234. doi: 10.3892/etm.2017.5190. Approximately, 10% become refractory to diuretic treatment and other treatment modalities should be considered [In patients with large grade 3 ascites or refractory ascites, LVP rapidly removes tense ascites and is the treatment of choice.
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Members of _ can log in with their society credentials belowJulie Steen Pedersen, Flemming Bendtsen, and Søren MøllerJulie Steen Pedersen, Flemming Bendtsen, and Søren MøllerCentre of Functional Imaging and Research, Department of Clinical Physiology and Nuclear Medicine, and Gastro Unit, Medical Division, Hvidovre Hospital, Faculty of Health Sciences, University of Copenhagen, DenmarkGastro Unit, Medical Division, Hvidovre Hospital, Faculty of Health Sciences, University of Copenhagen, DenmarkCentre of Functional Imaging and Research, Department of Clinical Physiology and Nuclear Medicine 239, Hvidovre Hospital, DK-2650 Hvidovre, Faculty of Health Sciences, University of Copenhagen, DenmarkCentre of Functional Imaging and Research, Department of Clinical Physiology and Nuclear Medicine, and Gastro Unit, Medical Division, Hvidovre Hospital, Faculty of Health Sciences, University of Copenhagen, DenmarkGastro Unit, Medical Division, Hvidovre Hospital, Faculty of Health Sciences, University of Copenhagen, DenmarkCentre of Functional Imaging and Research, Department of Clinical Physiology and Nuclear Medicine 239, Hvidovre Hospital, DK-2650 Hvidovre, Faculty of Health Sciences, University of Copenhagen, Denmark
The risks versus benefits of hernia repair must be weighed carefully in patients with cirrhosis and ascites. Patients with ascites are at high risk of developing complications such as spontaneous bacterial peritonitis, hyponatremia and progressive renal impairment. Sign in here to access free tools such as favourites and alerts, or to access personal subscriptionsIf you have access to journal content via a university, library or employer, sign in hereResearch off-campus without worrying about access issues.
The development of ascites is an important landmark in the natural history of cirrhosis as it is associated with a 50% mortality over two years and signifies the need to consider liver transplantation as a therapeutic option. In HRS there are no significant morphological changes in renal histology and these patients display a largely normal tubular function [The diagnostic criteria for HRS are illustrated in Suspicion of clinical ascites should be confirmed with abdominal ultrasound. A safe alternative therapyTransjugular intrahepatic portosystemic shunt for refractory ascites: a meta-analysis of individual patient dataDiagnosis, prevention and treatment of hepatorenal syndrome in cirrhosisRefractory ascites: pathogenesis, definition and therapy of a severe complication in patients with cirrhosisRenal distal tubular handling of sodium in central fluid volume homoeostasis in preascitic cirrhosisSpironolactone alone or in combination with furosemide in the treatment of moderate ascites in nonazotemic cirrhosis.
Epub 2015 Dec 10.Curr Treat Options Gastroenterol.
A randomized controlled study of 100 patientsThe serum-ascites albumin gradient is superior to the exudate-transudate concept in the differential diagnosis of ascitesTIPS versus paracentesis for cirrhotic patients with refractory ascitesClinical practice guidelines for the management of cirrhotic patients with ascites. The development of ascites is an important landmark in the natural history of cirrhosis as it is associated with a 50% mortality over two years and signifies the need to consider liver transplantation as a therapeutic option.
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Refractory ascites and hepatorenal syndrome are the complications of ascites that carry a very high mortality.