ReviewClinical and molecular hepatology2023
Management of refractory ascites.
Review in Clinical and molecular hepatology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
31 citing papers in PubMed, 51 citations in OpenAlex.
- Safety and efficacy of continuous infusion terlipressin (BIV201): A phase 2 trial in patients with decompensated cirrhosis and refractory ascites.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2025Trial
- KASL clinical practice guidelines for liver cirrhosis: Ascites and related complications 2026.Clinical and molecular hepatology · 2026Article
- Elective Transjugular Intrahepatic Portosystemic Shunt Creation in Cirrhosis Improves Body Composition and Function: Pilot Randomized Trial-Commentary.Cardiovascular and interventional radiology · 2026Article
- Direct venous-to-arterial communication as a novel mechanism for ectopic embolism following esophageal variceal embolization: A case report.Experimental and therapeutic medicine · 2026Article
- Integrated analysis of gut microbiota structure and metabolic function in patients with cirrhosis and refractory ascites.Biomedical reports · 2026Article
- Marked effect of topical application of Chinese medicine combined with moxibustion in a case of refractory malignant ascites in diffuse liver cancer.Frontiers in medicine · 2026Article
- Human Albumin-enriched Peritoneal Dialysis: A Novel Approach to Manage Refractory Ascites and Kidney Dysfunction in Decompensated Advanced Chronic Liver Disease.Journal of clinical and translational hepatology · 2025Article
- Acute kidney injury after TIPS in decompensated cirrhosis patients: a retrospective cohort study.BMC nephrology · 2025Article
- Future research direction of portal hypertension based on Baveno VII.Chinese medical journal · 2025Review
- Refractory Ascites in Patients With Cirrhosis.JGH open : an open access journal of gastroenterology and hepatology · 2025Article
- Impacts of salt restriction on nutritional status, sarcopenia, and mortality of cirrhotic patients with ascites.BMC gastroenterology · 2025Article
- Investigation of bending angle algorithm and path planning for puncture needles in transjugular intrahepatic portosystemic shunt.Biomedical engineering online · 2025Article
- A model predicting the 6-year all cause mortality of patients with advanced schistosomiasis after discharge: Derived from a large population-based cohort study.PLoS neglected tropical diseases · 2025Article
- Pharmacological Treatment of Ascites: Challenges and Controversies.Pharmaceuticals (Basel, Switzerland) · 2025Review
- Comparison of clinical outcomes of transjugular intrahepatic portosystemic shunt for refractory ascites and recurrent nonrefractory ascites.World journal of hepatology · 2025Article
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- Outpatient management after hospitalisation for acute decompensation of cirrhosis: A practical guide.World journal of hepatology · 2024Review
- Proximal splenic artery embolization for treatment of refractory ascites, a single-center experience.Hepatology research : the official journal of the Japan Society of Hepatology · 2024Article
- Drainage of ascites in cirrhosis.World journal of hepatology · 2024Review
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
Abstract
The development of refractory ascites in approximately 10% of patients with decompensated cirrhosis heralds the progression to a more advanced stage of cirrhosis. Its pathogenesis is related to significant hemodynamic changes, initiated by portal hypertension, but ultimately leading to renal hypoperfusion and avid sodium retention. Inflammation can also contribute to the pathogenesis of refractory ascites by causing portal microthrombi, perpetuating the portal hypertension. Many complications accompany the development of refractory ascites, but renal dysfunction is most common. Management starts with continuation of sodium restriction, which needs frequent reviews for adherence; and regular large volume paracentesis of 5 L or more with albumin infusions to prevent the development of paracentesisinduced circulatory dysfunction. Albumin infusions independent of paracentesis may have a role in the management of these patients. The insertion of a covered, smaller diameter, transjugular intrahepatic porto-systemic stent shunt (TIPS) in the appropriate patients with reasonable liver reserve can bring about improvement in quality of life and improved survival after ascites clearance. Devices such as an automated low-flow ascites pump may be available in the future for ascites treatment. Patients with refractory ascites should be referred for liver transplant, as their prognosis is poor. In patients with refractory ascites and concomitant chronic kidney disease of more than stage 3b, assessment should be referred for dual liver-kidney transplants. In patients with very advanced cirrhosis not suitable for any definitive treatment for ascites control, palliative care should be involved to improve the quality of life of these patients.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.