Ascites

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Treatment

  1. Salt restriction
    1. Effective in about 15% of patients
  2. Diuretics
    1. Spironolactone
      1. Starting dose = 100mg/day PO (max 400mg/day)
      2. 40% of patients will respond
    2. Furosemide
      1. 40 mg/day PO (max 160 mg/day)
      2. Ratio of 100:40 with spironolactone (reduces risks of potassium prob)



Water restriction

Paracentesis

Liver transplantation

Ascites that is refractory to medical therapy is considered an indication for liver transplantation. In the United States, the MELD score (online calculator)[1] is used to prioritize patients for transplantation.

Shunting