The International Ascites Club published the diagnostic criteria of refractory ascites, and hepatorenal syndrome.
Since this publication, there have been few studies assessing the natural history of ascites.
Dr Ricard Solà and colleagues from Spain defined the natural history of cirrhotic ascites.
The research team also identified prognostic factors for dilutional hyponatremia, refractory ascites, hepatorenal syndrome, and survival.
|1-year survival after developing refractory ascites was 32%|
|Clinical Gastroenterology & Hepatology|
The researchers followed 263 consecutive cirrhotic patients for 41 months after their first significant ascites.
During follow-up 28% of patients developed dilutional hyponatremia, 11% refractory ascites, and 7% hepatorenal syndrome.
The researchers found that the 5-year probability of developing dilutional hyponatremia and refractory ascites was 37% and 11%, respectively.
The 5-year probability of developing hepatorenal syndrome development was 11%.
The team observed that the probability of survival at 1 and 5 years was 85% and 57%, respectively.
The team noted that independent predictors for survival were baseline age, baseline Child-Pugh score, and dilutional hyponatremia development.
The 1-year probability of survival after developing dilutional hyponatremia and refractory ascites was 26% and 32%, respectively.
The researchers found that the 1-year probability of survival after developing type 2 hepatorenal syndrome was 39%.
In contrast, the mean survival was only 7 days in those patients developing type 1 hepatorenal syndrome.
Dr Solà's team concludes, “The survival of cirrhotic patients with first episode of ascites is relatively high.”
“It is mainly influenced by age and Child-Pugh score at the time of ascites decompensation, as well as by dilutional hyponatremia development.”
“The probability of refractory ascites, and hepatorenal syndrome development is relatively low, but they are associated with a poor prognosis.”