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ORIGINAL ARTICLE
Year : 2014  |  Volume : 26  |  Issue : 4  |  Page : 170-175

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


1 Department of Tropical Medicine; Department of Hepatology, Gastroenterology and Liver Transplant, Menoufiya University, Menoufia, Egypt
2 Department of Hepatology, Gastroenterology and Liver Transplant, Menoufiya University, Menoufia, Egypt
3 Department of Radiology, Menoufiya University, Menoufia, Egypt
4 Department of Clinical Biochemistry, National Liver Institute, Menoufiya University, Menoufia, Egypt

Correspondence Address:
Khaled Mohammad Attallah
3 Qenawy Street, Hassan Mohammad District, 12111 EL-Haram, Giza
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-7782.148164

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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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