Hemodynamic and renal eff'ects of ascites apheresb concentration reinfbsion in advanced cirrhosis

Background/Aims: We studied the effects of ascites apheresis, concentration and reinfusion, a new form of treatment for tense or refractory ascites, on systemic hemodynamics and renal function. Met/rods: Twelve patients with advanced cirrhosis (two belonging to Child-Pugh’s class B and the remainder to class C) were monitored. They were evaluated under baseline conditions, just after the treatment, and 24 and 48 h after baseline assessment. In addition to systemic hemodynamics - as evaluated by Doppler echocardiography - and renal function, indirect markers of effective volemia, such as atria1 natriuretic factor, plasma renin activity and aldosterone concentration, and plasma norepinephrine were also measured. Results: The technique led to significant changes in systemic hemodynamics, such as an increase in stroke volume and cardiac output. However, due to a striking reduction in peripheral vascular resistance, mean arterial pressure also declined. The hemodynamic changes were associated with a parallel increase in atria1 natriuretic factor. Despite the reduction in ar

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