Treatment of Ascites with Serum Sodium 121–125 mmol/l and Elevated Creatinine on Diuretic Therapy
Patients receiving ongoing diuretic treatment for ascites who develop a serum sodium of 121–125 mmol/l alongside an elevated serum creatinine present a specific, high-risk clinical picture that calls for immediate reassessment of the current approach.
Clinical Scenario
On diuretic therapy for ascites, with serum sodium 121–125 mmol/l and elevated serum creatinine (>150 mmol/l, or >120 mmol/l and rising).
Approach (partial)
The protocol covers management of current diuretic therapy together with volume status correction using a plasma expander. The specific agents, selection criteria, and monitoring framework are set out in the full structured regimen.
References
DOI: 10.1136/gut.2006.099580
- Serum sodium 121–125 mmol/l, serum creatinine elevated (.150 mmol/l or .120 mmol/l and rising). Stop diuretics and give volume expansion.
- Gelofusine, haemaccel, and 4.5% albumin solutions contain sodium concentrations equivalent to normal saline (154 mmol/l).