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The impact of large-volume paracentesis on renal haemodynamics in cirrhotic patients with ascites

The Egyptian Journal of Internal Medicine volume 26, pages 170–175 (2014)Cite this article

Abstract

Background and aim

Ascites in liver cirrhosis is associated with a poor prognosis and impairment of the quality of life and may be complicated by hepatorenal syndrome. Renal functions and haemodynamic changes after large-volume paracentesis (LVP) in cirrhotic patients with tense ascites were evaluated.

Patients and methods

A total of 50 cirrhotic patients with tense ascites were divided into two groups: group I 25 patients without renal impairment and group II 25 patients with renal impairment (type II hepatorenal syndrome).

Results

In groups I and II, the serum creatinine decreased significantly 24 h after LVP (P < 0.05 and 0.01, respectively). The glomerular filtration rate and the urine output increased significantly 24 h after LVP (P < 0.05, P < 0.01 and P < 0.01, P < 0.05, respectively, in groups I and II). The renal artery resistive index (RI) was significantly higher in group II compared with group I (P < 0.01). LVP caused a significant increase in the cardiac output, the stroke volume and the cardiac index (P < 0.01) and a significant decrease in the RI in both groups (P < 0.01). There was significant correlation between serum and ascetic fluid electrolyte levels in all patients.

Conclusion

LVP causes a significant reduction of heart rate and mean arterial pressure, serum creatinine, blood urea nitrogen and RI with a significant glomerular filtration rate increase, but had no effect on the plasma renin activity.

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Authors and Affiliations

  1. Department of Tropical Medicine, National Liver Institute, Menoufiya University, Menoufia, Egypt

    Tary Abdel-Hamid Salman & Khaled Mohammad Attallah MD

  2. Department of Hepatology, Gastroenterology and Liver Transplant, National Liver Institute, Menoufiya University, Menoufia, Egypt

    Tary Abdel-Hamid Salman, Hassan EL-Sayed Zaghla, Khaled Mohammad Attallah MD & Omkolthoum Mohammad El-Haddad

  3. Department of Radiology, National Liver Institute, Menoufiya University, Menoufia, Egypt

    Enas Mohammad Korayem

  4. Department of Clinical Biochemistry, National Liver Institute, Menoufiya University, Menoufia, Egypt

    Ashraf Abbass Basuni & Hossam El-Din Mahmoud El-Ezzawy

Authors
  1. Tary Abdel-Hamid Salman
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  2. Hassan EL-Sayed Zaghla
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  3. Khaled Mohammad Attallah MD
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  4. Omkolthoum Mohammad El-Haddad
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  6. Ashraf Abbass Basuni
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  7. Hossam El-Din Mahmoud El-Ezzawy
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Correspondence to Khaled Mohammad Attallah MD.

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Salman, T.AH., Zaghla, H.ES., Attallah, K.M. et al. The impact of large-volume paracentesis on renal haemodynamics in cirrhotic patients with ascites. Egypt J Intern Med 26, 170–175 (2014). https://doi.org/10.4103/1110-7782.148164

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  • DOI: https://doi.org/10.4103/1110-7782.148164

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