Treatment of Chronic Liver Failure in Liver Cirrhosis with Refractory Ascites

Clinical scenario

This protocol applies to patients with liver cirrhosis who have developed refractory ascites — fluid accumulation that is either diuretic-resistant or diuretic-intractable. The diagnosis of refractory ascites relies on the assessment of the response of ascites to diuretic therapy and salt restriction.

First-line approach (partial)

First-line management involves a procedural approach to fluid relief combined with albumin supplementation — an evidence-based strategy specifically recommended for this presentation.

The complete regimen, including sequencing and monitoring guidance, is available in the full protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.jhep.2018.03.024

The diagnosis of refractory ascites relies on the assessment of the response of ascites to diuretic therapy and salt restriction.
Repeated LVP plus albumin (8 g/L of ascites removed) are recommended as first line treatment for refractory ascites (I;1).

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