A Study on Clinical Features of Refractory Ascites in Patients with Cirrhosis

概要

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Forty-two patients with cirrhosis and ascites were studied to investigate clinical features of refractory ascites. Of these, 20 patients had responsive ascites and 22 had refractory ascites. Refractory ascites was defined by our criteria. The hepatic venous pressure gradient was significantly higher in patients with refractory ascites (20.5 ± 4.3 mmHg) than in patients with responsive ascites (18.0 ± 3.4 mmHg). Creatinine clearance in patients with refractory ascites (40.9 ± 22.8 ml/min) was significantly lower than in patients with responsive ascites (53.9 ± 19.0 ml/min). Concentrations of plasma renin activity, aldosterone and norepinephrine were significantly higher in patients with refractory ascites than in patients with responsive ascites. Liver function tests did not significantly differ between patients with refractory ascites and patients with responsive ascites. These results suggest that refractory ascites in patients with cirrhosis is associated with renal dysfunction and the activation of renin-angiotensin-aldosterone system and sympathetic nervous system. However, the severity of liver function tests is not related to the occurrence of refractory ascites. It is also suggested that portal pressure may have a potential role of the development of refractory ascites
The Japan Society for Portal Hypertensionの論文