Total paracentesis in cirrhotic patients with tense ascites and dilutional hyponatremia View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

1999-08

AUTHORS

Maria Carme Vila, Susanna Coll, Ricard Solà, Montserrat Andreu, Jordi Gana, Judith Marquez

ABSTRACT

OBJECTIVE: The safety of large-volume paracentesis with plasma expander infusion in ascitic cirrhotic patients with advanced liver disease, hyponatremia, or renal failure has not been elucidated. Our aim was to investigate the safety of total paracentesis in cirrhotic patients with ascites and severe hyponatremia. METHODS: Forty-five cirrhotic patients with tense ascites were treated with total paracentesis and infusion of plasma expanders. At inclusion, 20 patients showed severe hyponatremia (serum sodium <130 mEq/L). In the remaining 25 patients, serum sodium was >130 mEq/L (range, 133-146 mEq/L). RESULTS: Plasma renin activity (PRA) and plasma aldosterone concentration (PAC) were significantly higher in patients with hyponatremia (PRA: 19.7 +/- 5.8 ng/mL/h; PAC: 217 +/- 35 ng/dL) than in those patients without hyponatremia (PRA: 4.9 +/- 1.1 ng/mL/h; PAC: 95 +/- 31 ng/dL), indicating a more severe systemic hemodynamic deterioration. After paracentesis, PRA and PAC increased similarly in both groups of patients. Serum sodium levels remained unchanged after paracentesis in patients with hyponatremia (127 +/- 0.5 to 128 +/- 1.5 mEq/L) and decreased slightly in patients without hyponatremia (137 +/- 1 to 135 +/- 1 mEq/L; p < 0.005). The incidence of complications during the first hospitalization, the probability of readmission for complications of cirrhosis, and the probability of survival at 1 yr were similar in both groups of patients. CONCLUSIONS: These results indicate that therapeutic paracentesis is a safe treatment for tense ascites in cirrhotic patients with severe hyponatremia. More... »

PAGES

ajg1999526

Identifiers

URI

http://scigraph.springernature.com/pub.10.1111/j.1572-0241.1999.01296.x

DOI

http://dx.doi.org/10.1111/j.1572-0241.1999.01296.x

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1031304935

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/10445553


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