[Ascites].

Abstract

Ascites is most frequently a symptom of advanced chronic liver disease. The pathogenesis of ascites with portal hypertension is complex, and the interaction between liver and kidney is incompletely known. Due to the differing pathogenetic mechanisms and the consecutively different therapeutic approaches, the differential diagnosis of ascites has to be clearly evaluated by measurement of certain laboratory parameters in the ascitic fluid. The prior to therapy basic principles in the therapy of the portal ascites include bed rest, dietary restriction of sodium and water intake, therapeutic paracentesis and diuretics in increasing doses. With this basic therapeutic approach 85 to 90% of the patients can be treated successfully. In patients with complicated forms of ascites or hepatorenal syndrome, other therapeutic strategies have to be used.