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Q J Med 2001; 94: 293-300
© 2001 Association of Physicians

Review

Current management and novel therapeutic strategies for refractory ascites and hepatorenal syndrome

H. Suzuki and A.J. Stanley

From the Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK

The circulatory disturbances seen in advanced cirrhosis lead to the development of ascites, which can become refractory to diet and medical therapy. These abnormalities may progress and cause a functional renal failure known as the hepatorenal syndrome. Management of refractory ascites and hepatorenal syndrome is a therapeutic challenge, and if appropriate, liver transplantation remains the best treatment. New therapeutic options have recently appeared, including the transjugular intrahepatic portosystemic shunt and selective splanchnic vasoconstrictor agents, which may improve renal function and act as a bridge to transplantation.

Address correspondence to Dr A.J. Stanley, Consultant Gastroenterologist, c/o Ward 9, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 OSF. e-mail: adrian.stanley{at}northglasgow.scot.nhs.uk


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