Concentration-reinfusion (CR) of ascitic fluid in the treatment of decompensated liver cirrhosis with diuretic-resistant ascites

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Abstract
Summary: The ascites concentration-reinfusion as current therapeutic procedure is probably too expensive (but less expensive than desalinated human albumin) and in our opinion it is not a substitute for the diuretic drugs in diuretic-responsive ascites. On the other hand, this method plays an important role in the management of diuretic-resistant ascites. The mechanical extraction of the sequestered fluid and the infusion of a concentrated derivative into the blood stream beyond the portal blockade aim to restore the ‘effective’ blood volume, renal perfusion and GFR. This effect may induce a new responsive state of the kidney to diuretic drugs and may correct the functional renal failure. In addition, a well concentrated ascites supplies autologous proteins to those patients with gross abnormalities of serum protein concentrations.