Pathogenesis, Diagnosis and Treatment of Ascites in Cirrhosis

Professor of Hepatology, Université Denis Diderot Paris 7, Assistance Publique — Hôpitaux de Paris and Inserm U773, Service d'Hépatologie, Hôpital Beaujon, Clichy, France

Search for more papers by this author

Andres T. Blei MD,

Andres T. Blei MD

Professor of Medicine and Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA

Search for more papers by this author

Jürg Reichen MD,

Jürg Reichen MD

Professor of Medicine, University of Bern; Chief of Hepatology, University Hospital, Bern, Switzerland

Search for more papers by this author

Mario Rizzetto MD,

Mario Rizzetto MD

Professor of Gastroenterology, University of Turin, Turin, Italy

Search for more papers by this author

First published: 18 June 2007

https://doi.org/10.1002/9780470691861.ch7e

Citations: 2

References

Berner C, Davis JS, Riggs S et al. (1964) Diagnostic probabilities in patients with conspicuous ascites. Arch Intern Med 113, 687–690.
10.1001/archinte.1964.00280110067013
CAS PubMed Web of Science® Google Scholar
Lawson JD, Weissbein AS (1959) The puddle sign — an aid in the diagnosis of minimal ascites. N Engl J Med 260, 652–654.
10.1056/NEJM195903262601307
CAS PubMed Web of Science® Google Scholar
Cattau EL, Benjamin SB, Knuff TE et al. (1982) The accuracy of the physical examination in the diagnosis of suspected ascites. JAMA 247, 1164–1166.
PubMed Web of Science® Google Scholar
Branney SW, Wolfe RE, Moore EE et al. (1995) Quantitative sensitivity of ultrasound in detecting free intraperitoneal fluid. J Trauma Injury Infect Crit Care 39, 375–380.
10.1097/00005373-199508000-00032
CAS PubMed Web of Science® Google Scholar
Huning R (1973) Ultrasonic diagnosis of Wilms tumor. Fortschritte Gebiete Rontgenstrahl Nuklearmed 158–159.
Google Scholar
Wall SD, Hricak H, Bailey GD et al. (1986) MR imaging of pathological abdominal fluid collections. J Comp Assist Tomogr 10, 746–750.
10.1097/00004728-198609000-00006
CAS PubMed Web of Science® Google Scholar
Proto AV, Lane EJ (1976) Visualization of differences in soft-tissue densities — liver in ascites. Radiology 121, 19–23.
10.1148/121.1.19
CAS PubMed Web of Science® Google Scholar
Steinkampf MP, Blackwell RE, Younger JB (1991) Visualization of free peritoneal fluid with transvaginal sonography — a preliminary study. J Reprod Med 36, 729–730.
CAS PubMed Web of Science® Google Scholar
Edell SL, Gefter WB (1979) Ultrasonic differentiation of types of ascitic fluid. Am J Roentgenol 133, 111–114.
10.2214/ajr.133.1.111
CAS PubMed Web of Science® Google Scholar
Kedar RP, Shah PP, Shivde RS et al. (1994) Sonographic findings in gastroenterology and peritoneal tuberculosis. Clin Radiol 49, 24–29.
10.1016/S0009-9260(05)82909-5
CAS PubMed Web of Science® Google Scholar
Runyon BA, Montano AA, Akriviadis EA et al. (1992) The serum ascites albumin gradient is superior to the exudate-transudate concept in the differential diagnosis of ascites. Ann Intern Med 117, 215–220.
10.7326/0003-4819-117-3-215
CAS PubMed Web of Science® Google Scholar
Wilson JAP, Suguitan EA, Cassidy WA et al. (1979) Characteristics of ascitic fluid in the alcoholic cirrhotic. Dig Dis Sci 24, 645–648.
10.1007/BF01333710
PubMed Web of Science® Google Scholar
Sampline RE, Iber FL (1974) High protein ascites in patients with uncomplicated hepatic cirrhosis. Am J Med Sci 267, 275–279.
10.1097/00000441-197405000-00003
PubMed Web of Science® Google Scholar
Hoefs JC (1983) Serum protein concentration and portal pressure determine the ascitic fluid protein concentration in patients with chronic liver disease. J Lab Clin Med 102, 260–273.
CAS PubMed Web of Science® Google Scholar
Henriksen JH (1983) Permselectivity of the liver blood lymph (ascitic fluid) barrier to macromolecules in decompensated cirrhosis -relation to calculated pore size. Clin Physiol 3, 163–171.
10.1111/j.1475-097X.1983.tb00687.x
CAS PubMed Web of Science® Google Scholar
Henriksen JH, Lassen NA, Parving HH et al. (1980) Filtration as the main transport mechanism of protein exchange between plasma and the peritoneal-cavity in hepatic cirrhosis. Scand J Clin Lab Invest 40, 503–513.
10.3109/00365518009091957
CAS PubMed Web of Science® Google Scholar
Runyon BA, Vanepps DE (1986) Diuresis of cirrhotic ascites increases its opsonic activity and may help prevent spontaneous bacterial peritonitis. Hepatology 6, 396–399.
10.1002/hep.1840060311
PubMed Web of Science® Google Scholar
Fromkes JJ, Thomas FB, Mekhjian HS et al. (1977) Antimicrobial activity of human ascitic fluid. Gastroenterology 73, 668–672.
CAS PubMed Web of Science® Google Scholar
Simberkoff MS, Moldover NH, Weiss G (1978) Bactericidal and opsonic activity of cirrhotic ascites and nonascitic peritoneal fluid. J Lab Clin Med 91, 831–839.
PubMed Web of Science® Google Scholar
Runyon BA, Morrissey RL, Hoefs JC et al. (1985) Opsonic activity of human ascitic fluid — a potentially important protective mechanism against spontaneous bacterial peritonitis. Hepatology 5, 634–637.
10.1002/hep.1840050419
PubMed Web of Science® Google Scholar
Such J, Guarner C, Enriquez J et al. (1988) Low C-3 in cirrhotic ascites predisposes to spontaneous bacterial peritonitis. J Hepatol 6, 80–84.
10.1016/S0168-8278(88)80465-3
PubMed Web of Science® Google Scholar
Barmeir S, Lerner E, Conn HO (1979) Analysis of ascitic fluid in cirrhosis. Dig Dis Sci 24, 136–144.
10.1007/BF01324741
PubMed Web of Science® Google Scholar
Conn HO, Fessel JM (1971) Spontaneous bacterial peritonitis in cirrhosis — variations on a theme. Medicine 50, 161–197.
10.1097/00005792-197105000-00002
PubMed Web of Science® Google Scholar
Hoefs JC, Runyon BA (1985) Spontaneous bacterial peritonitis. Disease-A-Month 31, 1–48.
10.1016/0011-5029(85)90002-1
PubMed Web of Science® Google Scholar
Gitlin N, Stauffer JL, Silvestri RC (1982) The Ph of ascitic fluid in the diagnosis of spontaneous bacterial peritonitis in alcoholic cirrhosis. Hepatology 2, 408–411.
10.1002/hep.1840020403
PubMed Web of Science® Google Scholar
Stassen WN, McCullough AJ, Bacon BR et al. (1986) Immediate diagnostic-criteria for bacterial-infection of ascitic fluid — evaluation of ascitic fluid polymorphonuclear leukocyte count, Ph, and lactate concentration, alone and in combination. Gastroenterology 90, 1247–1254.
10.1016/0016-5085(86)90392-6
CAS PubMed Web of Science® Google Scholar
Garciatsao G, Conn HO, Lerner E (1985) The diagnosis of bacterial peritonitis — comparison of Ph, lactate concentration and leukocyte count. Hepatology 5, 91–96.
10.1002/hep.1840050119
PubMed Web of Science® Google Scholar
Hoefs JC (1981) Increase in ascites white blood cell and protein concentrations during diuresis in patients with chronic liver disease. Hepatology 1, 249–254.
10.1002/hep.1840010310
PubMed Web of Science® Google Scholar
Desitter L, Rector WG (1984) The significance of bloody ascites in patients with cirrhosis. Am J Gastroenterol 79, 136–138.
CAS PubMed Web of Science® Google Scholar
Dumont AE, Mulholland JH (1960) Flow rate and composition of thoracic-duct lymph in patients with cirrhosis. N Engl J Med 263, 471–474.
10.1056/NEJM196009082631001
CAS PubMed Web of Science® Google Scholar
Buo L, Karlsrud TS, Dyrhaug G et al. (1995) The fibrinolytic system in human ascites. Scand J Gastroenterol 30, 1101–1107.
10.3109/00365529509101614
CAS PubMed Web of Science® Google Scholar
Hoefs J, Barnes T, Halle P (1981) Intraperitoneal coagulation in chronic liver disease ascites. Dig Dis Sci 26, 518–522.
10.1007/BF01308100
CAS PubMed Web of Science® Google Scholar
Wilkinson SP, Henderson J, Davidson AR et al. (1975) Ascites reinfu-sion using rhodiascit apparatus — clinical experience and coagulation abnormalities. Postgrad Med J 51, 583–587.
10.1136/pgmj.51.598.583
CAS PubMed Web of Science® Google Scholar
Leveen HH, Ahmed N, Hutto RB et al. (1987) Coagulopathy post peritoneovenous shunt. Ann Surg 205, 305–311.
10.1097/00000658-198703000-00015
CAS PubMed Web of Science® Google Scholar
Bac DJ, Pruimboom WM, Mulder PGH et al. (1995) High interleukin-6 production within the peritoneal-cavity in decompensated cirrhosis and malignancy-related ascites. Liver 15, 265–270.
10.1111/j.1600-0676.1995.tb00683.x
CAS PubMed Web of Science® Google Scholar
Zeni F, Tardy B, Vindimian M et al. (1993) High levels of tumor necrosis factor alpha and interleukin-6 in the ascitic fluid of cirrhotic patients with spontaneous bacterial peritonitis. Clin Infect Dis 17, 218–223.
10.1093/clinids/17.2.218
PubMed Web of Science® Google Scholar
Navasa M, Follo A, Filella X et al. (1998) Tumor necrosis factor and interleukin-6 in spontaneous bacterial peritonitis in cirrhosis: relationship with the development of renal impairment and mortality. Hepatology 27, 1227–1232.
10.1002/hep.510270507
CAS PubMed Web of Science® Google Scholar
Cejudo P, Jimenez W, Ros J et al. (2001) Increased production of vascular endothelial growth factor in peritoneal macrophages of cirrhotic patients with spontaneous bacterial peritonitis. Hepatology 34, 184A.
Web of Science® Google Scholar
Giannini E, Romagnoli P, Tenconi GL et al. (2004) High ascitic fluid leptin levels in patients with decompensated liver cirrhosis and sterile ascites: relationship with TNF-alpha levels. Dig Dis Sci 49, 275–280.
10.1023/B:DDAS.0000017451.48031.b6
CAS PubMed Web of Science® Google Scholar
Runyon BA, Hoefs JC, Morgan TR (1988) Ascitic fluid analysis in malignancy-related ascites. Hepatology 8, 1104–1109.
10.1002/hep.1840080521
CAS PubMed Web of Science® Google Scholar
Rector WG, Reynolds TB (1984) Superiority of the serum ascites albumin difference over the ascites total protein concentration in separation of transudative and exudative ascites. Am J Med 77, 83–85.
10.1016/0002-9343(84)90440-6
PubMed Web of Science® Google Scholar
Garcia LW, Ducatman BS, Wang HH (1994) The value of multiple fluid specimens in the cytological diagnosis of malignancy. Mod Pathol 7, 665–668.
CAS PubMed Web of Science® Google Scholar
Prieto M, Gomezlechon MJ, Hoyos M et al. (1988) Diagnosis of malignant ascites — comparison of ascitic fibronectin, cholesterol, and serum-ascites albumin difference. Dig Dis Sci 33, 833–838.
10.1007/BF01550972
CAS PubMed Web of Science® Google Scholar
Gerbes AL, Jungst D, Xie YN et al. (1991) Ascitic fluid analysis for the differentiation of malignancy-related and nonmalignant ascites-proposal of a diagnostic sequence. Cancer 68, 1808–1814.
10.1002/1097-0142(19911015)68:8<1808::AID-CNCR2820680827>3.0.CO;2-6
CAS PubMed Web of Science® Google Scholar
Castaldo G, Oriani G, Cimino L et al. (1994) Total discrimination of peritoneal malignant ascites from cirrhosis-associated and hepatocarcinoma-associated ascites by assays of ascitic cholesterol and lactate dehydrogenase. Clin Chem 40, 478–483.
CAS PubMed Web of Science® Google Scholar
Hafter R, Klaubert W, Gollwitzer R et al. (1984) Crosslinked fibrin derivatives and fibronectin in ascitic fluid from patients with ovarian cancer compared to ascitic fluid in liver cirrhosis. Thromb Res 35, 53–64.
10.1016/0049-3848(84)90312-8
CAS PubMed Web of Science® Google Scholar
Gerbes AL, Hoermann R, Mann K et al. (1996) Human chorionic gonadotropin-beta in the differentiation of malignancy-related and nonmalignant ascites. Digestion 57, 113–117.
10.1159/000201324
CAS PubMed Web of Science® Google Scholar
Lee CM, Changchien CS, Shyu WC et al. (1992) Serum ascites albumin concentration gradient and ascites fibronectin in the diagnosis of malignant ascites. Cancer 70, 2057–2060.
10.1002/1097-0142(19921015)70:8<2057::AID-CNCR2820700807>3.0.CO;2-H
CAS PubMed Web of Science® Google Scholar
Chu CM, Lin SM, Peng SM et al. (1994) The role of laparoscopy in the evaluation of ascites of unknown origin. Gastrointest Endosc 40, 285–289.
10.1016/S0016-5107(94)70057-5
PubMed Web of Science® Google Scholar
Rector WG (1984) Spontaneous chylous ascites of cirrhosis. J Clin Gastroenterol 6, 369–372.
PubMed Web of Science® Google Scholar
Press OW, Press NO, Kaufman SD (1982) Evaluation and management of chylous ascites. Ann Intern Med 96, 358–364.
10.7326/0003-4819-96-3-358
CAS PubMed Web of Science® Google Scholar
Malagela JR, Iber FL, Linschee WG (1974) Origin of fat in chylous ascites of patients with liver cirrhosis. Gastroenterology 67, 878–886.
PubMed Web of Science® Google Scholar
Maywood BT, Goldstein L, Busuttil RW (1978) Chylous ascites after a Warren shunt. Am J Surg 135, 700–702.
10.1016/0002-9610(78)90139-3
CAS PubMed Web of Science® Google Scholar
Lingenfelser T, Zak J, Marks IN et al. (1993) Abdominal tuberculosis — still a potentially lethal disease. Am J Gastroenterol 88, 744–750.
CAS PubMed Web of Science® Google Scholar
Lundstedt C, Nyman R Brismar J et al. (1996) Imaging of tuberculosis. 2. Abdominal manifestations in 112 patients. Acta Radiol 37, 489–495.
10.1177/02841851960373P213
PubMed Web of Science® Google Scholar
Shakil AO, Korula J, Kanel GC et al. (1996) Diagnostic features of tuberculous peritonitis in the absence and presence of chronic liver disease: a case control study. Am J Med 100, 179–185.
10.1016/S0002-9343(97)89456-9
PubMed Web of Science® Google Scholar
Martinezvazquez JM, Ocana I, Ribera E et al. (1986) Adenosine deaminase activity in the diagnosis of tuberculous peritonitis. Gut 27, 1049–1053.
10.1136/gut.27.9.1049
PubMed Web of Science® Google Scholar
Hillebrand DJ, Runyon BA, Yasmineh WG et al. (1996) Ascitic fluid adenosine deaminase insensitivity in detecting tuberculous peritonitis in the United States. Hepatology 24, 1408–1412.
10.1002/hep.510240617
CAS PubMed Web of Science® Google Scholar
Wolfe JHN, Behn AR, Jackson BT (1979) Tuberculous peritonitis and role of diagnostic laparoscopy. Lancet 1, 852–853.
10.1016/S0140-6736(79)91266-2
CAS PubMed Web of Science® Google Scholar
Delope CR, Joglar GSM, Romero FP (1982) Laparoscopic diagnosis of tuberculous ascites. Endoscopy 14, 178–179.
10.1055/s-2007-1021615
PubMed Web of Science® Google Scholar
Bhargava DK, Shriniwa S, Chopra P et al. (1992) Peritoneal tuberculosis — laparoscopic patterns and its diagnostic accuracy. Am J Gastroenterol 87, 109–112.
PubMed Web of Science® Google Scholar
Holmes EC, Eggleston JC (1972) Starch granulomatous peritonitis. Surgery 71, 85–90.
CAS PubMed Web of Science® Google Scholar
Schwake L, von Herbay A, Junghanss T et al. (2003) Peritoneal tuberculosis with negative polymerase chain reaction results: report of two cases. Scand J Gastroenterol 38, 221–224.
CAS PubMed Web of Science® Google Scholar
Gamboa F, Dominguez J, Padilla E et al. (1998) Rapid diagnosis of extrapulmonary tuberculosis by ligase chain reaction amplification. J Clin Microbiol 36, 1324–1329.
CAS PubMed Web of Science® Google Scholar
Runyon BA (1988) Cardiac ascites — a characterization. J Clin Gastroenterol 10, 410–412.
10.1097/00004836-198808000-00013
CAS PubMed Web of Science® Google Scholar
Ackerman NB, Sillin LF, Suresh K (1985) Consequences of intraperitoneal bile — bile ascites versus bile peritonitis. Am J Surg 149, 244–246.
10.1016/S0002-9610(85)80078-7
CAS PubMed Web of Science® Google Scholar
Sankaran S, Walt AJ (1976) Pancreatic ascites — recognition and management. Arch Surg 111, 430–434.
10.1001/archsurg.1976.01360220126021
CAS PubMed Web of Science® Google Scholar
Maringhini A, Ciambra M, Patti R et al. (1996) Ascites, pleural, and pericardial effusions in acute pancreatitis — a prospective study of incidence, natural history, and prognostic role. Dig Dis Sci 41, 848–852.
10.1007/BF02091521
CAS PubMed Web of Science® Google Scholar
Boyer TD, Kahn AM, Reynolds TB (1978) Diagnostic value of ascitic fluid lactic-dehydrogenase, protein, and WBC levels. Arch Intern Med 138, 1103–1105.
10.1001/archinte.138.7.1103
CAS PubMed Web of Science® Google Scholar
Hammond TC, Takiyyuddin MA (1994) Nephrogenic ascites — a poorly understood syndrome. J Am Soc Nephrol 5, 1173–1177.
CAS PubMed Web of Science® Google Scholar
Balasch J, Arroyo V, Fabregues F et al. (1994) Neurohormonal and hemodynamic-changes in severe cases of the ovarian hyperstimula-tion syndrome. Ann Intern Med 121, 27–33.
10.7326/0003-4819-121-1-199407010-00005
CAS PubMed Web of Science® Google Scholar
Lieberman F, Hidemura R, Peters RL et al. (1966) Pathogenesis and treatment of hydrothorax complicating cirrhosis with ascites. Ann Intern Med 64, 341–351.
10.7326/0003-4819-64-2-341
PubMed Web of Science® Google Scholar
Lieberman F, Peters RL (1970) Cirrhotic hydrothorax. Further evidence that an acquired diaphragmatic defect is at fault. Arch Intern Med 125, 114.
10.1001/archinte.125.1.114
CAS PubMed Web of Science® Google Scholar
Singer JA, Kaplan MM, Katz RL (1977) Cirrhotic pleural effusion in absence of ascites. Gastroenterology 73, 575–577.
PubMed Web of Science® Google Scholar
Xiol X, Castellvi JM, Guardiola J et al. (1996) Spontaneous bacterial empyema in cirrhotic patients: a prospective study. Hepatology 23, 719–723.
10.1002/hep.510230410
PubMed Web of Science® Google Scholar
Mouroux J, Perrin C, Venissac N et al. (1996) Management of pleural effusion of cirrhotic origin. Chest 109, 1093–1096.
10.1378/chest.109.4.1093
PubMed Web of Science® Google Scholar
Witte MH, Witte CL, Dumont AE (1981) Estimated net trans-capillary water and protein flux in the liver and intestine of patients with portal-hypertension from hepatic cirrhosis. Gastroenterology 80, 265–272.
10.1016/0016-5085(81)90713-7
PubMed Web of Science® Google Scholar
Gnepp D (1984) Lymphatics. In: N Staub, AE Taylor (eds) Edema. New York: Raven Press, pp. 263–298.
Google Scholar
Laine GA, Hall JT, Laine SH et al. (1979) Trans-sinusoidal fluid-dynamics in canine liver during venous hypertension. Circ Res 45, 317–323.
10.1161/01.RES.45.3.317
CAS PubMed Web of Science® Google Scholar
Greenway CV, Lautt WW (1970) Effects of hepatic venous pressure on transsinusoidal fluid transfer in liver of anesthetized cat. Circ Res 26, 697–703.
10.1161/01.RES.26.6.697
CAS PubMed Web of Science® Google Scholar
Granger DN, Miller T, Allen R et al. (1979) Permselectivity of cat liver blood-lymph barrier to endogenous macromolecules. Gastroenterology 77, 103–109.
CAS PubMed Web of Science® Google Scholar
Granger DN, Barrowman J (1984) Gastroenterology and liver edema. In: N Staub, AE Taylor (eds) Edema. New York: Raven Press, pp. 615–656.
Google Scholar
Iber FL (1974) Normal and pathologic physiology of the liver. In: W Sodeman, WJ Sodeman (eds) Pathologic Physiology. Philadelphia: Saunders, pp. 790–817.
Google Scholar
Freeman S (1953) Recent progress in the physiology and biochemistry of the liver. Med Clin N Am 1, 109–124.
10.1016/S0025-7125(16)35043-X
CAS PubMed Google Scholar
Mallet-Guy P, Devic G, Feroldi J et al. (1954) Experimental study of ascites: posthepatic venous stenosis and transposition of the liver into the thorax. Lyon Chir 49, 153–172.
CAS PubMed Google Scholar
Richardson PDI, Granger DN, Mailman D et al. (1980) Permeability characteristics of colonic capillaries. Am J Physiol 239, G300–G305.
CAS PubMed Web of Science® Google Scholar
Mortillaro NA, Taylor AE (1976) Interaction of capillary and tissue forces in cat small-intestine. Circ Res 39, 348–358.
10.1161/01.RES.39.3.348
CAS PubMed Web of Science® Google Scholar
Witte CL, Witte MH, Dumont AE (1980) Lymph imbalance in the genesis and perpetuation of the ascites syndrome in hepatic cirrhosis. Gastroenterology 78, 1059–1068.
10.1016/0016-5085(80)90793-3
PubMed Web of Science® Google Scholar
Huet PM, Goresky CA, Villeneuve JP et al. (1982) Assessment of liver microcirculation in human cirrhosis. J Clin Invest 70, 1234–1244.
10.1172/JCI110722
PubMed Web of Science® Google Scholar
Vorobioff J, Bredfeldt JE, Groszmann RJ (1984) Increased blood flow through the portal system in cirrhotic rats. Gastroenterology 87, 1120–1126.
PubMed Web of Science® Google Scholar
Buhac I, Jarmolych J (1978) Histology of intestinal peritoneum in patients with cirrhosis of liver and ascites. Am J Dig Dis 23, 417–422.
10.1007/BF01072924
CAS PubMed Web of Science® Google Scholar
Witte MH, Witte CL, Dumont AE (1971) Progress in liver disease-physiological factors involved in causation of cirrhotic ascites. Gastroenterology 61, 742–750.
10.1016/S0016-5085(19)33439-0
PubMed Web of Science® Google Scholar
Witte CL, Witte MH, Cole WR et al. (1969) Dual origin of ascites in hepatic cirrhosis. Surg Gynecol Obstet/Int Abstracts Surg 129, 1027–1033.
CAS PubMed Web of Science® Google Scholar
Vorobioff J, Bredfeldt JE, Groszmann RJ (1983) Hyperdynamic circulation in portal-hypertensive rat model — a primary factor for maintenance of chronic portal-hypertension. Am J Physiol 244, G52–G57.
PubMed Web of Science® Google Scholar
Bosch J, Enriquez R, Groszmann RJ et al. (1983) Chronic bile-duct ligation in the dog — hemodynamic characterization of a portal hypertensive model. Hepatology 3, 1002–1007.
10.1002/hep.1840030618
CAS PubMed Web of Science® Google Scholar
Sugita S, Ohnishi K, Saito M et al. (1987) Splanchnic hemodynamics in portal hypertensive dogs with portal fibrosis. Am J Physiol 252, G748–G754.
PubMed Web of Science® Google Scholar
Korthuis RJ, Kinden DA, Brimer GE et al. (1988) Intestinal capillary filtration in acute and chronic portal-hypertension. Am J Physiol, 254 G339–G345.
PubMed Web of Science® Google Scholar
Benoit JN, Granger DN (1986) Splanchnic hemodynamics in chronic portal hypertension. Semin Liver Dis 6, 287–298.
10.1055/s-2008-1040611
PubMed Web of Science® Google Scholar
Kiel JW, Pitts V, Benoit JN et al. (1985) Reduced vascular sensitivity to norepinephrine in portal-hypertensive rats. Am J Physiol 248, G192–G195.
CAS PubMed Web of Science® Google Scholar
Benoit JN, Korthuis RJ, Granger DN et al. (1990) Splanchnic hemodynamics in acute and chronic portal hypertension. In: A Bomzon, L Blendis (eds) Cardiovascular Complications of Liver Disease. Boca Raton: CRC Press, pp. 179–206.
Google Scholar
Groszmann RJ (1995) Mechanisms of portal hypertension. In: V Arrovo, J Bosch, J Rodes (eds) Treatments in Hepatology. Barcelona: Masson SA, pp. 3–8.
Google Scholar
Huet PM, Pomierlayrargues G, Villeneuve JP et al. (1986) Intrahepatic circulation in liver disease. Semin Liver Dis 6, 277–286.
10.1055/s-2008-1040610
CAS PubMed Web of Science® Google Scholar
Bosch J, Mastai R, Kravetz D et al. (1985) Measurement of azygous venous blood flow in the evaluation of portal hypertension in patients with cirrhosis — clinical and hemodynamic correlations in 100 patients. J Hepatol 1, 125–139.
10.1016/S0168-8278(85)80761-3
CAS PubMed Web of Science® Google Scholar
Bosch J, Arroyo V, Betriu A et al. (1980) Hepatic hemodynamics and the renin-angiotensin-aldosterone system in cirrhosis. Gastroenterology 78, 92–99.
PubMed Web of Science® Google Scholar
Kotelanski B, Groszman R, Cohn JN (1972) Circulation times in splanchnic and hepatic beds in alcoholic liver disease. Gastroenterology 63, 102–111.
10.1016/S0016-5085(19)33356-6
PubMed Web of Science® Google Scholar
Arroyo V, Rodes J (1975) Rational approach to treatment of ascites. Postgrad Med J 51, 558–562.
10.1136/pgmj.51.598.558
PubMed Web of Science® Google Scholar
Jimenez W, Martinezpardo A, Arroyo V et al. (1985) Temporal relationship between hyper-aldosteronism, sodium retention and ascites formation in rats with experimental cirrhosis. Hepatology 5, 245–250.
10.1002/hep.1840050215
CAS PubMed Web of Science® Google Scholar
Caregaro L, Lauro S, Angeli P et al. (1985) Renal water and sodium handling in compensated liver-cirrhosis — mechanism of the impaired natriuresis after saline loading. Eur J Clin Invest 15, 360–364.
10.1111/j.1365-2362.1985.tb00285.x
PubMed Web of Science® Google Scholar
Naccarato R, Messa P, Dangelo A et al. (1981) Renal handling of sodium and water in early chronic liver-disease — evidence for a reduced natriuretic activity of the cirrhotic urinary extracts in rats. Gastroenterology 81, 205–210.
PubMed Web of Science® Google Scholar
Wong F, Massie D, Hsu P et al. (1994) Renal response to a saline load in well-compensated alcoholic cirrhosis. Hepatology 20, 873–881.
10.1002/hep.1840200415
PubMed Web of Science® Google Scholar
Wilkinson SP, Smith IK, Moodie H et al. (1979) Studies on mineralo-corticoid escape in cirrhosis. Clin Sci 56, 401–406.
10.1042/cs0560401
CAS PubMed Web of Science® Google Scholar
Lavilla G, Salmeron JM, Arroyo V et al. (1992) Mineralocorticoid escape in patients with compensated cirrhosis and portal hypertension. Gastroenterology 102, 2114–2119.
10.1016/0016-5085(92)90340-5
CAS PubMed Web of Science® Google Scholar
Trevisani F, Bernardi M, Gasbarrini A et al. (1992) Bed-rest-induced hypernatriuresis in cirrhotic-patients without ascites — does it contribute to maintain compensation? J Hepatol 16, 190–196.
10.1016/S0168-8278(05)80114-X
CAS PubMed Web of Science® Google Scholar
Bernardi M, Dimarco C, Trevisani F et al. (1993) Renal sodium retention during upright posture in preascitic cirrhosis. Gastroenterology 105, 188–193.
10.1016/0016-5085(93)90025-8
PubMed Web of Science® Google Scholar
Papper S, Rosenbaum JD (1952) Abnormalities in the excretion of water and sodium in compensated cirrhosis of the liver. J Lab Clin Med 40, 523–530.
CAS PubMed Web of Science® Google Scholar
Shear L, Hall PW, Gabuzda GJ (1965) Renal failure in patients with cirrhosis of liver. 2. factors influencing maximal urinary flow rate. Am J Med 39, 199–209.
10.1016/0002-9343(65)90042-2
CAS PubMed Web of Science® Google Scholar
Epstein M (1985) Derangements of renal water handling in liver disease. Gastroenterology 89, 1415–1425.
10.1016/0016-5085(85)90664-X
PubMed Web of Science® Google Scholar
Arroyo V, Rodes J, Gutierrezlizarraga MA et al. (1976) Prognostic value of spontaneous hyponatremia in cirrhosis with ascites. Am J Dig Dis 21, 249–256.
10.1007/BF01095898
PubMed Web of Science® Google Scholar
Rodes J, Brugera M, Teres J et al. (1970) Terminal functional renal insufficiency (TFRI) in liver cirrhosis with ascites. Rev Clin Esp 117, 475–482.
CAS PubMed Google Scholar
Gines A, Escorsell A, Gines P et al. (1993) Incidence, predictive factors, and prognosis of the hepatorenal-syndrome in cirrhosis with ascites. Gastroenterology 105, 229–236.
10.1016/0016-5085(93)90031-7
CAS PubMed Web of Science® Google Scholar
Llach J, Gines P, Arroyo V et al. (1988) Prognostic value of arterial pressure, endogenous vasoactive systems, and renal function in cirrhotic patients admitted to the hospital for the treatment of ascites. Gastroenterology 94, 482–487.
10.1016/0016-5085(88)90441-6
CAS PubMed Web of Science® Google Scholar
Rodes J, Arroyo V, Bosch J (1975) Clinical types and drug therapy of renal impairment in cirrhosis. Postgrad Med J 51, 492–497.
10.1136/pgmj.51.598.492
PubMed Web of Science® Google Scholar
Arroyo V, Gines P, Gerbes AL et al. (1996) Definition and diagnostic criteria of refractory ascites and hepatorenal syndrome in cirrhosis. Hepatology 23, 164–176.
10.1002/hep.510230122
CAS PubMed Web of Science® Google Scholar
Laragh J, Sealey JE (1992) Renin-angiotensin-aldosterone system and the regulation of sodium, potassium and blood pressure homeostasis. In: E Windhager (ed.) Handbook of Physiology: Renal Physiology. New York: Oxford University Press, pp. 1409–1542.
Google Scholar
Simon MA, Diez J, Prieto J (1991) Abnormal sympathetic and renal response to sodium restriction in compensated cirrhosis. Gastroenterology 101, 1354–1360.
10.1016/0016-5085(91)90088-3
CAS PubMed Web of Science® Google Scholar
Salo J, Gines A, Anibarro L et al. (1995) Effect of upright posture and physical exercise on endogenous neurohormonal systems in cirrhotic patients with sodium retention and normal supine plasma renin, aldosterone, and norepinephrine levels. Hepatology 22, 479–487.
10.1002/hep.1840220217
CAS PubMed Web of Science® Google Scholar
Wilkinson SP, Jowett TP, Slater JDH et al. (1979) Renal sodium retention in cirrhosis — relation to aldosterone and nephron site. Clin Sci 56, 169–177.
10.1042/cs0560169
CAS PubMed Web of Science® Google Scholar
Perezayuso RM, Arroyo V, Planas R et al. (1983) Randomized comparative study of efficacy of furosemide versus spironolactone in nonazotemic cirrhosis with ascites — relationship between the diuretic response and the activity of the renin-aldosterone system. Gastroenterology 84, 961–968.
PubMed Web of Science® Google Scholar
Kotelanski B, Groszman R, Cohn JN (1972) Circulation times in splanchnic and hepatic beds in alcoholic liver disease. Gastroenterology 63, 102–111.
10.1016/S0016-5085(19)33356-6
PubMed Web of Science® Google Scholar
Nicholls KM, Shapiro MD, Vanputten VJ et al. (1985) Elevated plasma norepinephrine concentrations in decompensated cirrhosis-association with increased secretion rates, normal clearance rates, and suppressibility by central blood volume expansion. Circ Res 56, 457–461.
10.1161/01.RES.56.3.457
CAS PubMed Web of Science® Google Scholar
Henriksen J, Ring-Larsen H, Christensen N (1985) Circulating noradrenaline and central haemodynamics in patients with cirrhosis. Scand J Gastroenterol 20, 1185–1190.
10.3109/00365528509089274
CAS PubMed Web of Science® Google Scholar
Lieberman F, Reynolds TB (1967) Plasma volume in cirrhosis of liver — its relation to portal hypertension ascites and renal failure. J Clin Invest 46, 1297–1308.
10.1172/JCI105622
CAS PubMed Web of Science® Google Scholar
Arroyo V, Bosch J, Mauri M et al. (1981) Effect of angiotensin-II blockade on systemic and hepatic hemodynamics and on the renin-angiotensin-aldosterone system in cirrhosis with ascites. Eur J Clin Invest 11, 221–229.
10.1111/j.1365-2362.1981.tb01844.x
CAS PubMed Web of Science® Google Scholar
Perezayuso RM, Arroyo V, Camps J et al. (1984) Renal kallikrein excretion in cirrhotics with ascites — relationship to renal hemodynamics. Hepatology 4, 247–252.
10.1002/hep.1840040213
CAS PubMed Web of Science® Google Scholar
Arroyo V, Planas R, Gaya J et al. (1983) Sympathetic nervous activity, renin-angiotensin system and renal excretion of prostaglandin-e2 in cirrhosis — relationship to functional renal failure and sodium and water excretion. Eur J Clin Invest 13, 271–278.
10.1111/j.1365-2362.1983.tb00100.x
PubMed Web of Science® Google Scholar
Tobey JC, Weaver LC (1987) Pressoreceptor modulation of renal but not splenic sympathetic reflexes. Am J Physiol 252, R26–R33.
CAS PubMed Web of Science® Google Scholar
Robertson GL (1992) Regulation of vasopressin secretion. In: D Seldin, G Giebisch (eds) The Kidney: Physiology and Pathophysiology. New York: Raven Press, pp. 1595–1614.
Google Scholar
Barajas L, Muller J (1973) Innervation of juxtaglomerular apparatus and surrounding tubules — quantitative-analysis by serial section electron microscopy. J Ultrastruct Res 43, 107–132.
10.1016/S0022-5320(73)90073-7
CAS PubMed Web of Science® Google Scholar
Kopp U, DiBona G (1992) Neural control of renal function. In: D Seldin, G Giebisch (eds) The Kidney: Physiology and Pathophysiology. New York: Raven Press, pp. 1157–1204.
Google Scholar
Bichet DG, Vanputten VJ, Schrier RW (1982) Potential role of increased sympathetic activity in impaired sodium and water excretion in cirrhosis. N Engl J Med 307, 1552–1557.
10.1056/NEJM198212163072504
PubMed Web of Science® Google Scholar
Ringlarsen H, Hesse B, Henriksen JH et al. (1982) Sympathetic nervous activity and renal and systemic hemodynamics in cirrhosis-plasma norepinephrine concentration, hepatic extraction, and renal release. Hepatology 2, 304–310.
10.1002/hep.1840020303
PubMed Web of Science® Google Scholar
Maroto A, Gines P, Arroyo V et al. (1993) Brachial and femoral artery blood flow in cirrhosis — relationship to kidney dysfunction. Hepatology 17, 788–793.
10.1002/hep.1840170507
PubMed Web of Science® Google Scholar
Solisherruzo JA, Duran A, Favela V et al. (1987) Effects of lumbar sympathetic block on kidney function in cirrhotic patients with hepatorenal syndrome. J Hepatol 5, 167–173.
10.1016/S0168-8278(87)80569-X
PubMed Web of Science® Google Scholar
Ishikawa S, Schrier RW (2003) Pathophysiological roles of arginine vasopressin and aquaporin-2 in impaired water excretion. Clin Endocrinol 58, 1–17.
10.1046/j.1365-2265.2003.01647.x
CAS PubMed Web of Science® Google Scholar
Ishikawa S, Saito T, Kasono K (2004) Pathological role of aquaporin-2 in impaired water excretion and hyponatremia. J Neuroendocrinol 16, 293–296.
10.1111/j.0953-8194.2004.01177.x
CAS PubMed Web of Science® Google Scholar
Jamison R, Gehrig JJ (1992) Urinary concentration and dilution. In: E Windhager (ed.) Handbook of Physiology: Section 8, Renal Physiology. New York: Oxford University Press, pp. 1219–1280.
Google Scholar
Perezayuso RM, Arroyo V, Camps J et al. (1984) Evidence that renal prostaglandins are involved in renal water metabolism in cirrhosis. Kidney Int 26, 72–80.
10.1038/ki.1984.136
CAS PubMed Web of Science® Google Scholar
Linas SL, Anderson RJ, Guggenheim SJ et al. (1981) Role of vasopressin in impaired water-excretion in conscious rats with experimental cirrhosis. Kidney Int 20, 173–180.
10.1038/ki.1981.119
CAS PubMed Web of Science® Google Scholar
Claria J, Jimenez W, Arroyo V et al. (1989) Blockade of the hydroos-motic effect of vasopressin normalizes water excretion in cirrhotic rats. Gastroenterology 97, 1294–1299.
10.1016/0016-5085(89)91702-2
CAS PubMed Web of Science® Google Scholar
Gerbes AL, Golberg V, Gines P et al. (2003) Therapy of hyponatremia in cirrhosis with a vasopressin receptor antagonist: a randomized double-blind multicenter trial. Gastroenterology 124, 933–939.
10.1053/gast.2003.50143
CAS PubMed Web of Science® Google Scholar
Wong F, Blei AT, Blendis LM et al. (2003) A vasopressin receptor antagonist (VPA-985) improves serum sodium concentration in patients with hyponatremia: a multicenter, randomized, placebo-controlled trial. Hepatology 37, 182–191.
10.1053/jhep.2003.50021
CAS PubMed Web of Science® Google Scholar
Gines P, Wong F, Milutinovic S et al. (2006) Effects of satavaptan (SR121463B), a selective vasopressin V2 receptor antagonist, on serum sodium concentration and ascites in patients with cirrhosis and hyponatremia. J Hepatol 44 (2), S270.
10.1016/S0168-8278(06)80732-4
Web of Science® Google Scholar
Bosch-Marcé M, Jimenez W, Angeli P et al. (1995) Aquaretic effect of the kappa-opioid agonist Ru-51599 in cirrhotic rats with ascites and water retention. Gastroenterology 109, 217–223.
10.1016/0016-5085(95)90287-2
CAS PubMed Web of Science® Google Scholar
Smith WL (1992) Prostanoid biosynthesis and mechanisms of action. Am J Physiol 263, F181–F191.
CAS PubMed Web of Science® Google Scholar
Schnermann J, Briggs JP (1981) Participation of renal cortical prostaglandins in the regulation of glomerular filtration rate. Kidney Int 19, 802–815.
10.1038/ki.1981.84
CAS PubMed Web of Science® Google Scholar
Conrad K, Dunn M (1992) Renal prostaglandins and other eicosanoids. In: E Windhager (ed.) Handbook of Physiology: Section 8, Renal Physiology. New York: Oxford University Press, pp. 1708–1757.
Google Scholar
Rimola A, Gines P, Arroyo V et al. (1986) Urinary excretion of 6-keto-prostaglandin F1-alpha, thromboxane B-2 and prostaglandin-E2 in cirrhosis with ascites — relationship to functional renal failure (hepatorenal syndrome). J Hepatol 3, 111–117.
10.1016/S0168-8278(86)80154-4
CAS PubMed Web of Science® Google Scholar
Moore K, Ward PS, Taylor GW et al. (1991) Systemic and renal production of thromboxane-A2 and prostacyclin in decompensated liver disease and hepatorenal syndrome. Gastroenterology 100, 1069–1077.
10.1016/0016-5085(91)90284-R
CAS PubMed Web of Science® Google Scholar
Boyer TD, Zia P, Reynolds TB (1979) Effect of indomethacin and prostaglandin-A1 on renal function and plasma renin activity in alcoholic liver disease. Gastroenterology 77, 215–222.
CAS PubMed Web of Science® Google Scholar
Lianos EA, Alavi N, Tobin M et al. (1982) Angiotensin-induced sodium-excretion patterns in cirrhosis — role of renal prostaglandins. Kidney Int 21, 70–77.
10.1038/ki.1982.10
CAS PubMed Web of Science® Google Scholar
Wong F, Massie D, Hsu P, Dudley F (1993) Indomethacin-induced renal dysfunction in patients with well-compensated cirrhosis. Gastroenterology 104, 869–876.
10.1016/0016-5085(93)91024-C
CAS PubMed Web of Science® Google Scholar
Lianos EA, Alavi N, Tobin M et al. (1982) Angiotensin-induced sodium-excretion patterns in cirrhosis — role of renal prostaglandins. Kidney Int 21, 70–77.
10.1038/ki.1982.10
CAS PubMed Web of Science® Google Scholar
Claria J, Kent JD, Lopez-Parra M et al. (2005) Effects of celecoxib and naproxen on renal function in nonazotemic patients with cirrhosis and ascites. Hepatology 41, 579–587.
10.1002/hep.20595
CAS PubMed Web of Science® Google Scholar
Abelmann WH (1994) Hyperdynamic circulation in cirrhosis-a historical perspective. Hepatology 20, 1356–1358.
10.1002/hep.1840200537
CAS PubMed Web of Science® Google Scholar
Fernandez-Seara J, Prieto J, Quiroga J et al. (1989) Systemic and regional hemodynamics in patients with liver cirrhosis and ascites with and without functional renal-failure. Gastroenterology 97, 1304–1312.
10.1016/0016-5085(89)91704-6
PubMed Web of Science® Google Scholar
Guevara M, Bru C, Gines P et al. (1998) Increased cerebrovascular resistance in cirrhotic patients with ascites. Hepatology 28, 39–44.
10.1002/hep.510280107
CAS PubMed Web of Science® Google Scholar
Morales-Ruiz M, Tugues S, Cejudo-Martin P et al. (2005) Ascites from cirrhotic patients induces angiogenesis through the phospho-inositide 3-kinase/Akt signaling pathway. J Hepatol 43, 85–91.
10.1016/j.jhep.2005.01.035
CAS PubMed Web of Science® Google Scholar
Wiest R, Das S, Cadelina G et al. (1999) Bacterial translocation in cirrhotic rats stimulates eNOS-derived NO production and impairs mesenteric vascular contractility. J Clin Invest 104, 1223–1233.
10.1172/JCI7458
CAS PubMed Web of Science® Google Scholar
Xu LM, Carter EP, Ohara M et al. (2000) Neuronal nitric oxide synthase and systemic vasodilation in rats with cirrhosis. Am J Physiol (Renal Physiol) 279, F1110–F1115.
10.1152/ajprenal.2000.279.6.F1110
CAS PubMed Web of Science® Google Scholar
Martin PY, Ohara M, Gines P et al. (1998) Nitric oxide synthase (NOS) inhibition for one week improves renal sodium and water excretion in cirrhotic rats with ascites. J Clin Invest 101, 235–242.
10.1172/JCI626
CAS PubMed Web of Science® Google Scholar
Wiest R, Groszmann RJ (2002) The paradox of nitric oxide in cirrhosis and portal hypertension: too much, not enough. Hepatology 35, 478–491.
10.1053/jhep.2002.31432
CAS PubMed Web of Science® Google Scholar
Li Y, Song D, Zhang Y et al. (2003) Effect of neonatal capsaicin treatment on haemodynamics and renal function in cirrhotic rats. Gut 52, 293–299.
10.1136/gut.52.2.293
CAS PubMed Web of Science® Google Scholar
Gupta S, Morgan TR, Gordan GS (1992) Calcitonin gene-related peptide in hepatorenal-syndrome — a possible mediator of peripheral vasodilation. J Clin Gastroenterol 14, 122–126.
10.1097/00004836-199203000-00010
CAS PubMed Web of Science® Google Scholar
Fernandezrodriguez CM, Prieto J, Quiroga J et al. (1995) Plasma levels of substance P in liver cirrhosis — relationship to the activation of vasopressor systems and urinary sodium excretion. Hepatology 21, 35–40.
10.1016/0270-9139(95)90405-0
CAS PubMed Web of Science® Google Scholar
Chang CS, Chen GH, Lien HC et al. (1998) Small intestine dysmotil-ity and bacterial overgrowth in cirrhotic patients with spontaneous bacterial peritonitis. Hepatology 28, 1187–1190.
10.1002/hep.510280504
CAS PubMed Web of Science® Google Scholar
Ruiz-del-Arbol L, Monescillo A, Arocena C et al. (2005) Circulatory function and hepatorenal syndrome in cirrhosis. Hepatology 42, 439–447.
10.1002/hep.20766
CAS PubMed Web of Science® Google Scholar
Ros J, Claria J, Jimenez W et al. (1995) Role of nitric oxide and prostacyclin in the control of renal perfusion in experimental cirrhosis. Hepatology 22, 915–920.
10.1002/hep.1840220332
CAS PubMed Web of Science® Google Scholar
Angeli P, Jimenez W, Arroyo V et al. (1994) Renal effects of natriuretic peptide receptor blockade in cirrhotic rats with ascites. Hepatology 20, 948–954.
10.1002/hep.1840200425
CAS PubMed Web of Science® Google Scholar
Ruiz-del-Arbol W, Urman J, Fernandez J et al. (2003) Systemic, renal, and hepatic hemodynamic derangement in cirrhotic patients with spontaneous bacterial peritonitis. Hepatology 38, 1210–1218.
10.1053/jhep.2003.50447
CAS PubMed Web of Science® Google Scholar
Moller S, Henriksen JH (2002) Cirrhotic cardiomyopathy: a pathophysiological review of circulatory dysfunction in liver disease. Heart 87, 9–15.
10.1136/heart.87.1.9
CAS PubMed Web of Science® Google Scholar
Witte CL, Witte MH, Dumont AE (1980) Lymph imbalance in the genesis and perpetuation of the ascites syndrome in hepatic cirrhosis. Gastroenterology 78, 1059–1068.
10.1016/0016-5085(80)90793-3
PubMed Web of Science® Google Scholar
Schrier RW, Arroyo V, Bernardi M et al. (1988) Peripheral arterial vasodilation hypothesis — a proposal for the initiation of renal sodium and water-retention in cirrhosis. Hepatology 8, 1151–1157.
10.1002/hep.1840080532
CAS PubMed Web of Science® Google Scholar
Benoit JN, Barrowman JA, Harper SL et al. (1984) Role of humoral factors in the intestinal hyperemia associated with chronic portal-hypertension. Am J Physiol 247, G486–G493.
PubMed Web of Science® Google Scholar
Benoit JN, Granger DN (1988) Intestinal microvascular adaptation to chronic portal hypertension in the rat. Gastroenterology 94, 471–476.
10.1016/0016-5085(88)90439-8
CAS PubMed Web of Science® Google Scholar
Arroyo V, Gines P (1992) Arteriolar vasodilation and the pathogenesis of the hyperdynamic circulation and renal sodium and water-retention in cirrhosis. Gastroenterology 102, 1077–1079.
10.1016/0016-5085(92)90203-B
PubMed Web of Science® Google Scholar
Leak LV, Rahil K (1978) Permeability of diaphragmatic mesothelium — ultrastructural basis for stomata. Am J Anat 151, 557–593.
10.1002/aja.1001510409
CAS PubMed Web of Science® Google Scholar
Tsilibary EC, Wissig SL (1977) Absorption from peritoneal-cavity-SEM study of mesothelium covering peritoneal surface of muscular portion of diaphragm. Am J Anat 149, 127–133.
10.1002/aja.1001490111
CAS PubMed Web of Science® Google Scholar
Yoffey J, Courtice F (1970) Lymph flow and regional lymphatics. In: E Arnold (ed.) Lymphatics, Lymph and Lymphomyeloid Complex. New York: Academia, pp. 356–443.
Google Scholar
Buhac I, Flesh L, Kishore R (1984) Intraabdominal pressure and resorption of ascites in decompensated liver cirrhosis. J Lab Clin Med 104, 264–270.
CAS PubMed Web of Science® Google Scholar
Arroyo V, Gines P, Planas R et al. (1986) Management of patients with cirrhosis and ascites. Semin Liver Dis 6, 353–369.
10.1055/s-2008-1040617
PubMed Web of Science® Google Scholar
Arroyo V, Bosch J, Gayabeltran J et al. (1981) Plasma renin activity and urinary sodium excretion as prognostic indicators in nona-zotemic cirrhosis with ascites. Ann Intern Med 94, 198–201.
10.7326/0003-4819-94-2-198
PubMed Web of Science® Google Scholar
Tage-Jensen U, Henriksen JH, Christensen E et al. (1988) Plasma catecholamine level and portal venous pressure as guides to prognosis in patients with cirrhosis. J Hepatol 6, 350–358.
10.1016/S0168-8278(88)80053-9
PubMed Web of Science® Google Scholar
Salerno F, Borroni G, Moser P et al. (1993) Survival and prognostic factors of cirrhotic patients with ascites — a study of 134 outpatients. Am J Gastroenterol 88, 514–519.
CAS PubMed Web of Science® Google Scholar
Guardiola J, Xiol X, Escriba JM et al. (1995) Prognosis assessment of cirrhotic patients with refractory ascites treated with a peritoneoven-ous shunt. Am J Gastroenterol 90, 2097–2102.
PubMed Web of Science® Google Scholar
Ruf AE, Kremers WK, Chavez LL et al. (2005) Addition of serum sodium into the MELD score predicts waiting list mortality better than MELD alone. Liver Transplant 11, 336–343.
10.1002/lt.20329
PubMed Web of Science® Google Scholar
Heuman DM, Abou-assi SG, Habib A et al. (2004) Persistent ascites and low serum sodium identify patients with cirrhosis and low MELD scores who are at high risk for early death. Hepatology 40, 802–810.
10.1002/hep.20405
PubMed Web of Science® Google Scholar
Schepke M, Roth F, Koch L et al. (2003) Prognostic impact of renal impairment and sodium imbalance in patients undergoing trans-jugular intrahepatic portosystemic shunting for the prevention of variceal rebleeding. Digestion 67, 146–153.
10.1159/000071294
PubMed Web of Science® Google Scholar
Borroni G, Maggi A, Sangiovanni A et al. (2000) Clinical relevance of hyponatraemia for the hospital outcome of cirrhotic patients. Dig Liver Dis 32, 605–610.
10.1016/S1590-8658(00)80844-0
CAS PubMed Web of Science® Google Scholar
Salo J, Guevara M, Fernandez Esparrach G et al. (1997) Impairment of renal function during moderate physical exercise in cirrhotic patients with ascites: relationship with the activity of neurohormonal systems. Hepatology 25, 1338–1342.
10.1002/hep.510250606
CAS PubMed Web of Science® Google Scholar
Gines P, Arrovo V, Rodes J (1992) Pharmacotherapy of ascites associated with cirrhosis. Drugs 43, 316–332.
10.2165/00003495-199243030-00003
CAS PubMed Web of Science® Google Scholar
Moore KP, Wong F, Gines P et al. (2003) The management of ascites in cirrhosis: report on the consensus conference of the international ascites club. Hepatology 38, 258–266.
10.1053/jhep.2003.50315
PubMed Web of Science® Google Scholar
Suki W, Eknoyan G (1992) Physiology of diuretic action. In: D Seldin, G Giebisch (eds) The Kidney: Physiology and Pathophysiology, 2nd edn. New York: Raven, pp. 3629–3670.
Google Scholar
Puschett J, Winaver J (1992) Effects of diuretics on renal function. In: E Windhager (ed.) Handbook of Physiology: Section 8, Renal Physiology. New York: Oxford University Press, pp. 2335–2407.
Google Scholar
Karim A (1986) Spironolactone metabolism in man revisited. In: H Brumer (ed.) Contemporary Trends in Diuretic Therapy. Amsterdam: Excerpta Medica, pp. 23–27.
Google Scholar
Sungaila I, Bartle WR, Walker SE et al. (1992) Spironolactone pharmacokinetics and pharmacodynamics in patients with cirrhotic ascites. Gastroenterology 102, 1680–1685.
10.1016/0016-5085(92)91730-R
PubMed Web of Science® Google Scholar
Sawhney VK, Gregory PB, Swezey SE et al. (1981) Furosemide disposition in cirrhotic patients. Gastroenterology 81, 1012–1016.
CAS PubMed Web of Science® Google Scholar
Pinzani M, Daskalopoulos G, Laffi G et al. (1987) Altered furosemide pharmacokinetics in chronic alcoholic liver disease with ascites contributes to diuretic resistance. Gastroenterology 92, 294–298.
10.1016/0016-5085(87)90120-X
PubMed Web of Science® Google Scholar
Traeger A, Hantze R, Penzlin M et al. (1985) Pharmacokinetics and pharmacodynamic effects of furosemide in patients with liver cirrhosis. Int J Clin Pharmacol Therapeut 23, 129–133.
CAS PubMed Web of Science® Google Scholar
Villeneuve JP, Verbeeck RK, Wilkinson GR et al. (1986) Furosemide kinetics and dynamics in patients with cirrhosis. Clin Pharmacol Therapeut 40, 14–20.
10.1038/clpt.1986.132
CAS PubMed Web of Science® Google Scholar
Gatta A, Angeli P, Caregaro L et al. (1991) A pathophysiological interpretation of unresponsiveness to spironolactone in a stepped-care approach to the diuretic treatment of ascites in nonazotemic cirrhotic patients. Hepatology 14, 231–236.
10.1002/hep.1840140205
PubMed Web of Science® Google Scholar
Bernardi M, Laffi G, Salvagnini M et al. (1993) Efficacy and safety of the stepped care medical treatment of ascites in liver cirrhosis — a randomized controlled clinical trial comparing 2 diets with different sodium content. Liver 13, 156–162.
10.1111/j.1600-0676.1993.tb00624.x
PubMed Web of Science® Google Scholar
Forns X, Gines A, Gines P et al. (1994) Management of ascites and renal failure in cirrhosis. Semin Liver Dis 14, 82–96.
10.1055/s-2007-1007300
CAS PubMed Web of Science® Google Scholar
Santos J, Planas R, Pardo A et al. (2003) Spironolactone alone or in combination with furosemide in the treatment of moderate ascites in nonazotemic cirrhosis. A randomized comparative study of efficacy and safety. J Hepatol 39, 187–192.
10.1016/S0168-8278(03)00188-0
CAS PubMed Web of Science® Google Scholar
Shear L, Ching S, Gabuzda GJ (1970) Compartmentalization of ascites and edema in patients with hepatic cirrhosis. N Engl J Med 282, 1391.
10.1056/NEJM197006182822502
PubMed Web of Science® Google Scholar
Sherlock S, Senewira B, Scott A et al. (1966) Complications of diuretic therapy in hepatic cirrhosis. Lancet 1, 1049–1052.
10.1016/S0140-6736(66)91005-1
PubMed Web of Science® Google Scholar
Strauss E, de Sa M, Laut C (1985) Standardization of therapeutic approach for ascites due to chronic liver disease. A prospective study of 100 cases. Gastroenterol Endosc Dig 4, 79–86.
Google Scholar
Angeli P, Albino G, Carraro P et al. (1996) Cirrhosis and muscle cramps: evidence of a causal relationship. Hepatology 23, 264–273.
10.1002/hep.510230211
CAS PubMed Web of Science® Google Scholar
Lee FY, Lee SD, Tsai YT et al. (1991) A randomized controlled trial of quinidine in the treatment of cirrhotic-patients with muscle cramps. J Hepatol 12, 236–240.
10.1016/0168-8278(91)90944-7
CAS PubMed Web of Science® Google Scholar
Planas R, Arroyo V, Rimola A et al. (1983) Acetylsalicylic acid suppresses the renal hemodynamic effect and reduces the diuretic action of furosemide in cirrhosis with ascites. Gastroenterology 84, 247–252.
CAS PubMed Web of Science® Google Scholar
Mirouze D, Zipser RD, Reynolds TB (1983) Effect of inhibitors of prostaglandin synthesis on induced diuresis in cirrhosis. Hepatology 3, 50–55.
10.1002/hep.1840030108
CAS PubMed Web of Science® Google Scholar
Gines P, Arroyo V, Quintero E et al. (1987) Comparison of paracentesis and diuretics in the treatment of cirrhotics with tense ascites-results of a randomized study. Gastroenterology 93, 234–241.
10.1016/0016-5085(87)91007-9
CAS PubMed Web of Science® Google Scholar
Gines P, Tito L, Arroyo V et al. (1988) Randomized comparative study of therapeutic paracentesis with and without intravenous albumin in cirrhosis. Gastroenterology 94, 1493–1502.
10.1016/0016-5085(88)90691-9
PubMed Web of Science® Google Scholar
Gines A, Fernandez Esparrach G, Monescillo A et al. (1996) Randomized trial comparing albumin, dextran 70, and polygeline in cirrhotic patients with ascites treated by paracentesis. Gastroenterology 111, 1002–1010.
10.1016/S0016-5085(96)70068-9
CAS PubMed Web of Science® Google Scholar
Ruiz-del-Arbol L, Monescillo A, Jimenez W et al. (1997) Paracentesis-induced circulatory dysfunction: mechanism and effect on hepatic hemodynamics in cirrhosis. Gastroenterology 113, 579–586.
10.1053/gast.1997.v113.pm9247479
CAS PubMed Web of Science® Google Scholar
Sola-Vera J, Minana J, Ricart E et al. (2003) Randomized trial comparing albumin and saline in the prevention of paracentesis-induced circulatory dysfunction in cirrhotic patients with ascites. Hepatology 37, 1147–1153.
10.1053/jhep.2003.50169
CAS PubMed Web of Science® Google Scholar
LeVeen HH, Christou G, Ip M et al. (1974) Peritoneo-venous shunting for ascites. Ann Surg 180, 580–591.
10.1097/00000658-197410000-00023
PubMed Web of Science® Google Scholar
Fulenwider JT, Galambos JD, Smith RB et al. (1986) Denver periton-eovenous shunts for intractable ascites of cirrhosis — a randomized, prospective trial. Arch Surg 121, 351–355.
10.1001/archsurg.1986.01400030113018
CAS PubMed Web of Science® Google Scholar
Schroeder ET, Anderson GH, Smulyan H (1979) Effects of a portacaval or peritoneovenous shunt on renin in the hepatorenal syndrome. Kidney Int 15, 54–61.
10.1038/ki.1979.8
PubMed Web of Science® Google Scholar
Smadja C, Franco D (1985) The Leveen shunt in the elective treatment of intractable ascites in cirrhosis — a prospective study on 140 patients. Ann Surg 201, 488–493.
10.1097/00000658-198504000-00014
CAS PubMed Web of Science® Google Scholar
Lund RH, Moritz MW (1982) Complications of Denver peritoneovenous shunting. Arch Surg 117, 924–928.
10.1001/archsurg.1982.01380310038009
CAS PubMed Web of Science® Google Scholar
Harmon DC, Demirjian Z, Ellman L et al. (1979) Disseminated intravascular coagulation with the peritoneovenous shunt. Ann Intern Med 90, 774–776.
10.7326/0003-4819-90-5-774
CAS PubMed Web of Science® Google Scholar
Stein SF, Fulenwider JT, Ansley JD et al. (1981) Accelerated fibrinogen and platelet destruction after peritoneovenous shunting. Arch Intern Med 141, 1149–1151.
10.1001/archinte.141.9.1149
CAS PubMed Web of Science® Google Scholar
Tang HH, Salem HH, Wood LJ et al. (1992) Coagulopathy during ascites reinfusion — prevention by antiplatelet therapy. Gastroenterology 102, 1334–1339.
10.1016/0016-5085(92)90773-R
CAS PubMed Web of Science® Google Scholar
Ginès A, Planas R, Angeli P et al. (1995) Treatment of patients with cirrhosis and refractory ascites using leveen shunt with titanium tip-comparison with therapeutic paracentesis. Hepatology 22, 124–131.
10.1002/hep.1840220120
PubMed Web of Science® Google Scholar
Greenlee HB, Stanley MM, Reinhardt GF (1981) Intractable ascites treated with peritoneovenous shunts (LeVeen) — a 24-month to 64-month follow-up of results in 52 alcoholic cirrhotics. Arch Surg 116, 518–524.
10.1001/archsurg.1981.01380170016003
CAS PubMed Web of Science® Google Scholar
Wapnick S, Grosberg SJ, Evans MI (1979) Randomized prospective matched pair study comparing peritoneovenous shunt and conventional therapy in massive ascites. Br J Surg 66, 667–670.
10.1002/bjs.1800660924
CAS PubMed Web of Science® Google Scholar
Bories P, Garcia Compean D, Michel H et al. (1986) The treatment of refractory ascites by the LeVeen shunt. A multi-centre controlled trial (57 patients). J Hepatol 3, 212–218.
10.1016/S0168-8278(86)80028-9
CAS PubMed Web of Science® Google Scholar
Ringlarsen H, Siemssen O, Krintel JJ et al. (1988) Diuretic resistant ascites in cirrhosis treated with peritoneo-venous shunt — a randomized controlled trial. Hepatology 8, 1353.
Web of Science® Google Scholar
Stanley MM, Ochi S, Lee KK et al. (1989) Peritoneovenous shunting as compared with medical-treatment in patients with alcoholic cirrhosis and massive ascites. N Engl J Med 321, 1632–1638.
10.1056/NEJM198912143212403
PubMed Web of Science® Google Scholar
Gines P, Arroyo V, Vargas V et al. (1991) Paracentesis with intravenous infusion of albumin as compared with peritoneovenous shunting in cirrhosis with refractory ascites. N Engl J Med 325, 829–835.
10.1056/NEJM199109193251201
PubMed Web of Science® Google Scholar
Orloff MJ (1970) Pathogenesis and surgical treatment of intractable ascites associated with alcoholic cirrhosis. Ann NY Acad Sci 170, 213.
10.1111/j.1749-6632.1970.tb37015.x
CAS Web of Science® Google Scholar
Franco D (1983) Treatment of intractable ascites in cirrhotic-patients by portal-systemic shunt. Gastroenterol Clin Biol 7, 533–539.
CAS PubMed Web of Science® Google Scholar
Arrovo V, Cardenas A (1999) TIPS in the treatment of refractory ascites. In: V Arrovo, J Bosch, M Bruguera et al.(eds) Treatment of Liver Diseases. Barcelona: Masson, pp. 43–51.
Google Scholar
Lebrec D, Giuily N, Hadengue A et al. (1996) Transjugular intrahepatic portosystemic shunts: comparison with paracentesis in patients with cirrhosis and refractory ascites: a randomized trial. J Hepatol 25, 135–144.
10.1016/S0168-8278(96)80065-1
PubMed Web of Science® Google Scholar
Rossle M, Ochs A, Gulberg V et al. (2000) A comparison of paracentesis and transjugular intrahepatic portosystemic shunting in patients with ascites. N Engl J Med 342, 1701–1707.
10.1056/NEJM200006083422303
CAS PubMed Web of Science® Google Scholar
Salerno F, Merli M, Riggio O et al. (2004) Randomized controlled study of TIPS versus paracentesis plus albumin in cirrhosis with severe ascites. Hepatology 40, 629–635.
10.1002/hep.20364
CAS PubMed Web of Science® Google Scholar
Gines P, Uriz J, Calahorra B et al. (2002) Transjugular intrahepatic portosystemic shunting versus paracentesis plus albumin for refractory ascites in cirrhosis. Gastroenterology 123, 1839–1847.
10.1053/gast.2002.37073
PubMed Web of Science® Google Scholar
Sanyal AJ, Genning C, Reddy KR et al. (2003) The North American study for the treatment of refractory ascites. Gastroenterology 124, 634–641.
10.1053/gast.2003.50088
PubMed Web of Science® Google Scholar
Campbell NS, Brensinger CM, Sanyal AJ et al. (2005) Quality of life in refractory ascites: transjugular intrahepatic portal-systemic shunting versus medical therapy. Hepatology 42, 635–640.
10.1002/hep.20840
PubMed Web of Science® Google Scholar
Londono MC, Guevara M, Rimola A et al. (2006) Hyponatremia impairs early posttransplantation outcome in patients with cirrhosis undergoing liver transplantation. Gastroenterology 130, 1135–1143.
10.1053/j.gastro.2006.02.017
PubMed Web of Science® Google Scholar
Carrilho F, Bosch J, Arroyo V et al. (1977) Renal failure associated with demeclocycline in cirrhosis. Ann Intern Med 87, 195–197.
10.7326/0003-4819-87-2-195
CAS PubMed Web of Science® Google Scholar
Perezayuso RM, Arroyo V, Camps J et al. (1984) Effect of demeclocycline on renal-function and urinary prostaglandin-E2 and kallikrein in hyponatremic cirrhotics. Nephron 36, 30–37.
10.1159/000183112
CAS PubMed Web of Science® Google Scholar
Ohnishi A, Orita Y, Okahara R et al. (1993) Potent aquaretic agent — a novel nonpeptide selective vasopressin-2 antagonist (Opc-31260) in men. J Clin Invest 92, 2653–2659.
10.1172/JCI116881
CAS PubMed Web of Science® Google Scholar
Tsuboi Y, Ishikawa SE, Fujisawa G et al. (1994) Therapeutic efficacy of the nonpeptide AVP antagonist Opc-31260 in cirrhotic rats. Kidney Int 46, 237–244.
10.1038/ki.1994.265
CAS PubMed Web of Science® Google Scholar
Bosch-Marcé M, Poo JL, Jimenez W et al. (1999) Comparison of two aquaretic drugs (niravoline and OPC-31260) in cirrhotic rats with ascites and water retention. J Pharmacol Exp Therapeut 289, 194–201.
CAS PubMed Web of Science® Google Scholar
Jimenez W, Serradeil-Le Gal C, Ros J et al. (2000) Long-term aquaretic efficacy of a selective nonpeptide V-2-vasopressin receptor antagonist, SR121463, in cirrhotic rats. J Pharmacol Exp Therapeut 295, 83–90.
PubMed Web of Science® Google Scholar
Fernández-Varol G, Ros J, Cejudo-Martin P et al. (2003) Effect of the V-1a/V-2-AVP receptor antagonist, conivaptan, on renal water metabolism and systemic hemodynamics in rats with cirrhosis and ascites. J Hepatol 38, 755–761.
10.1016/S0168-8278(03)00116-8
PubMed Web of Science® Google Scholar
Inoue T, Ohnishi A, Matsuo A et al. (1998) Therapeutic and diagnostic potential of a vasopressin-2 antagonist for impaired water handling in cirrhosis. Clin Pharmacol Therapeut 63, 561–570.
10.1016/S0009-9236(98)90107-2
CAS PubMed Web of Science® Google Scholar
Guyader D, Patat A, Ellis-Grosse EJ et al. (2002) Pharmacodynamic effects of a nonpeptide antidiuretic hormone V2 antagonist in cirrhotic patients with ascites. Hepatology 36, 1197–1205.
10.1053/jhep.2002.36375
CAS PubMed Web of Science® Google Scholar
Wong F, Blei AT, Blendis LM et al. (2003) A vasopressin receptor antagonist (VPA-985) improves serum sodium concentration in patients with hyponatremia: a multicenter, randomized, placebo-controlled trial. Hepatology 37, 182–191.
10.1053/jhep.2003.50021
CAS PubMed Web of Science® Google Scholar
Gerbes AL, Golberg V, Gines P et al. (2003) Therapy of hyponatremia in cirrhosis with a vasopressin receptor antagonist: a randomized double-blind multicenter trial. Gastroenterology 124, 933–939.
10.1053/gast.2003.50143
CAS PubMed Web of Science® Google Scholar
Gadano A, Moreau R, Pessione F et al. (2000) Aquaretic effects of niravoline, a kappa-opioid agonist, in patients with cirrhosis. J Hepatol 32, 38–42.
10.1016/S0168-8278(00)80187-7
CAS PubMed Web of Science® Google Scholar
Cabrera J, Arroyo V, Ballesta AM et al. (1982) Aminoglycoside nephrotoxicity in cirrhosis — value of urinary beta-2-microglobulin to discriminate functional renal failure from acute tubular damage. Gastroenterology 82, 97–105.
CAS PubMed Web of Science® Google Scholar
Moore RD, Smith CR, Lipsky JJ et al. (1983) Analysis of risk for development of aminoglycoside nephrotoxicity. Clin Res 31, A251.
Web of Science® Google Scholar
Arroyo V, Perezayuso RM, Camps J et al. (1983) Evidence that renal prostaglandin-E2 (Pge2) plays a major role in the maintenance of water excretion in cirrhosis. Hepatology 3, 856.
Google Scholar
Zipser RD, Hoefs JC, Speckart PF et al. (1979) Prostaglandins-modulators of renal function and pressor resistance in chronic liver disease. J Clin Endocrinol Metab 48, 895–900.
10.1210/jcem-48-6-895
PubMed Web of Science® Google Scholar
Levy M, Wexler MJ, Fechner C (1983) Renal perfusion in dogs with experimental hepatic cirrhosis — role of prostaglandins. Am J Physiol 245, F521–F529.
CAS PubMed Web of Science® Google Scholar
Bosch-Marce M, Claria J, Titos E et al. (1999) Selective inhibition of cyclooxygenase 2 spares renal function and prostaglandin synthesis in cirrhotic rats with ascites. Gastroenterology 116, 1167–1175.
10.1016/S0016-5085(99)70020-X
CAS PubMed Web of Science® Google Scholar
Lopez-Parra M, Claria J, Planaguma A et al. (2002) Cyclooxygenase-1 derived prostaglandins are involved in the maintenance of renal function in rats with cirrhosis and ascites. Br J Pharmacol 135, 891–900.
10.1038/sj.bjp.0704528
CAS PubMed Web of Science® Google Scholar
Lopez-Parra M, Claria J, Titos E et al. (2005) The selective cyclooxygenase-2 inhibitor celecoxib modulates the formation of vasoconstrictor eicosanoids and activates PPAR gamma. Influence of albumin. J Hepatol 42, 75–81.
10.1016/j.jhep.2004.09.011
CAS PubMed Web of Science® Google Scholar
Gines A, Salmeron JM, Gines P et al. (1992) Effects of somatostatin on renal function in cirrhosis. Gastroenterology 103, 1868–1874.
10.1016/0016-5085(92)91446-B
PubMed Web of Science® Google Scholar
Mountokalakis T, Kallivretakis N, Mayopoulousymvoulidou D et al. (1988) Enhancement of renal-function by a long-acting somatostatin analog in patients with decompensated cirrhosis. Nephrol Dialys Transplant 3, 604–607.
10.1093/oxfordjournals.ndt.a091713
PubMed Web of Science® Google Scholar
Bernardi M, Depalma R, Trevisani F et al. (1989) Renal function and effective beta-blockade in cirrhosis with ascites — relationship with baseline sympathoadrenergic tone. J Hepatol 8, 279–286.
10.1016/0168-8278(89)90024-X
CAS PubMed Web of Science® Google Scholar
Salmeron JM, Delarbol LR, Gines A et al. (1993) Renal effects of acute isosorbide-5-mononitrate administration in cirrhosis. Hepatology 17, 800–806.
10.1002/hep.1840170509
PubMed Web of Science® Google Scholar
Salerno F, Borroni G, Lorenzano E et al. (1996) Long-term administration of isosorbide-5-mononitrate does not impair renal function in cirrhotic patients. Hepatology 23, 1135–1140.
10.1002/hep.510230530
CAS PubMed Web of Science® Google Scholar
Vorobioff J, Picabea E, Gamen M et al. (1993) Propranolol compared with propranolol plus isosorbide dinitrate in portal-hypertensive patients — long-term hemodynamic and renal effects. Hepatology 18, 477–484.
10.1002/hep.1840180302
CAS PubMed Web of Science® Google Scholar
Morillas RM, Planas R, Cabre E et al. (1994) Propranolol plus isosorbide-5-mononitrate for portal hypertension in cirrhosis-long-term hemodynamic and renal effects. Hepatology 20, 1502–1508.
10.1002/hep.1840200620
PubMed Web of Science® Google Scholar
Merkel C, Gatta A, Donada C et al. (1995) Long-term effect of nadolol or nadolol plus isosorbide-5-mononitrate on renal function and ascites formation in patients with cirrhosis. Hepatology 22, 808–813.
10.1002/hep.1840220318
CAS PubMed Web of Science® Google Scholar
Albillos A, Lledo JL, Rossi I et al. (1995) Continuous prazosin administration in cirrhotic-patients — effects on portal hemodynamics and on liver and renal function. Gastroenterology 109, 1257–1265.
10.1016/0016-5085(95)90586-3
CAS PubMed Web of Science® Google Scholar

Citing Literature

Textbook of Hepatology: From Basic Science to Clinical Practice, Third Edition