What does refractory ascites mean?
What does refractory ascites mean?
Refractory ascites, that is ascites which cannot be mobilized by low sodium diet and maximal doses of diuretics (up to 400 mg spironolactone or potassium canrenoate and 160 mg furosemide per day), occurs in 5% of cirrhotic patients with ascites.
What is the difference between ascites and refractory ascites?
Refractory ascites is defined as ascites that does not recede after medical therapy or that reoccurs shortly after fluid has been removed from the abdominal cavity via paracentesis.
How do beta blockers work in cirrhosis?
By slowing the heart rate and widening the blood vessels, beta-blocker medicines such as propranolol and nadolol appear to lower the blood pressure in varices that bypass the liver. In people who have esophageal varices, beta-blockers have been shown to reduce the risk of having a first episode of bleeding.
How is refractory ascites treated?
Therapy for refractory ascites is limited. The available therapies are repeated large volume paracentesis (LVP), transjugular intrahepatic portosystemic shunts, peritoneovenous shunts, investigational medical therapies, and liver transplantation. LVP with concomitant volume expanders is the initial treatment of choice.
Does ascites mean you are dying?
What Is Ascites? Ascites can cause liver disease and cirrhosis, and death. The organs of the abdomen are contained in a sac or membrane called the peritoneum.
How long can you live with refractory ascites?
In the absence of liver transplantation, a diagnosis of refractory ascites confers a median life expectancy of ≤6 months [3,4,5]. End-of-life care in patients with ESLD and refractory ascites has not been a research priority.
Why is spironolactone used for ascites?
1 Spironolactone. Spironolactone is an aldosterone antagonist, acting mainly on the distal tubules to increase natriuresis and conserve potassium. Spironolactone is the drug of choice in the initial treatment of ascites due to cirrhosis.
What is the mechanism of action of beta blockers?
Beta blockers work by blocking the effects of the hormone epinephrine, also known as adrenaline. Beta blockers cause the heart to beat more slowly and with less force, which lowers blood pressure. Beta blockers also help widen veins and arteries to improve blood flow.
How common is refractory ascites?
Refractory ascites is intractable and occurs in 5%–10% of all patients with ascites due to cirrhosis. Refractory ascites leads to a poor quality of life and high mortality rate. Ascites develops as a result of portal hypertension, which leads to water–sodium retention and renal failure.
What is life expectancy with ascites?
The probability of survival at one and five years after the diagnosis of ascites is approximately 50 and 20%, respectively, and long-term survival of more than 10 years is very rare [8]. In addition, mortality rises up to 80% within 6–12 months in patients who also develop kidney failure [1].
Does ascites mean end of life?
Background: Malignant ascites is a manifestation of end stage events in a variety of cancers and associated with a poor prognosis.
What is the best medicine for ascites?
Drugs used to treat Ascites
| Drug name | Rating | Rx/OTC |
|---|---|---|
| Generic name: furosemide systemic Drug class: loop diuretics For consumers: dosage, interactions, side effects For professionals: Prescribing Information | ||
| View information about hydrochlorothiazide / spironolactone hydrochlorothiazide / spironolactone | Rate | Rx |
