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Current Hepatology Reports
Erschienen in: Current Hepatology Reports 3/2014

01.09.2014 | Portal Hypertension (JC Garcia-Pagán, Section Editor)

From Refractory Ascites to Dilutional Hyponatremia and Hepatorenal Syndrome: Current Options for Treatment

verfasst von: Elsa Solà, Isabel Graupera, Pere Ginès

Erschienen in: Current Hepatology Reports | Ausgabe 3/2014

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Abstract

Cirrhosis is associated with high morbidity rates due to complications of portal hypertension. Ascites is the most frequent complication in patients with cirrhosis, and refractory ascites will develop in approximately 10 % of patients during follow-up. Currently, the first-line treatment for patients with refractory ascites is large-volume paracentesis with albumin supplementation. In more advanced stages of the disease, dilutional hyponatremia may develop as the result of nonosmotic hypersecretion of vasopressin. Although vaptans have shown promising results as a potential pharmacologic approach to treating hypervolemic hyponatremia, their results on long-term efficacy and safety in patients with cirrhosis are not conclusive. Moreover, because of concerns regarding side effects, the US Food and Drug Administration recently removed the indication of tolvaptan for use in patients with cirrhosis. Finally, in late stages of the disease, intense renal vasoconstriction occurs and leads to the development of hepatorenal syndrome. The treatment of choice for patients with hepatorenal syndrome is vasoconstrictor drugs followed by liver transplantation.
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Metadaten
Titel
From Refractory Ascites to Dilutional Hyponatremia and Hepatorenal Syndrome: Current Options for Treatment
verfasst von
Elsa Solà
Isabel Graupera
Pere Ginès
Publikationsdatum
01.09.2014
Verlag
Springer US
Erschienen in
Current Hepatology Reports / Ausgabe 3/2014
Elektronische ISSN: 2195-9595
DOI
https://doi.org/10.1007/s11901-014-0240-8

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