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    Planas R, Montoliu S, Ballesté B, Rivera M, Miquel M, Masnou H, et al. Multicenter hospital study on prescribing patterns for prophylaxis and treatment of complications of cirrhosis. Through complex mechanisms mediated in part by nitric oxide, PHTN results in splanchnic arterial vasodilation, which leads to decreased systemic vascular resistance and lower effective arterial volume (). Current management of the complications of cirrhosis and portal hypertension: variceal hemorrhage, ascites, and spontaneous bacterial peritonitis. Natural history of patients hospitalized for management of cirrhotic ascites. As liver disease advances and PHTN worsens, the decrease in effective arterial volume becomes more pronounced and increases in cardiac output are no longer able to compensate. However, diuretics and paracentesis should both be avoided in the presence of conditions that further decrease the effective arterial volume, such as variceal hemorrhage, spontaneous bacterial peritonitis, and acute renal failure (ARF) (9. Lucena MI, Andrade RJ, Tognoni G, Hidalgo R, De La Cuesta FS; Spanish Collaborative Study Group On Therapeutic Management In Liver Disease. Cirrhotic ascites formation begins with the development of portal hypertension (PHTN) (). Management and treatment of patients with cirrhosis and portal hypertension: recommendations from the Department of Veterans Affairs Hepatitis C Resource Center Program and the National Hepatitis C Program. Effect of intravenous albumin on renal impairment and mortality in patients with cirrhosis and spontaneous bacterial peritonitis. Incidence and predictive factors of first episode of spontaneous bacterial peritonitis in cirrhosis with ascites: relevance of ascitic fluid protein concentration. This article will review current recommendations for the treatment of ascites, including hepatorenal syndrome and spontaneous bacterial peritonitis. Garcia-Tsao G, Lim JK, Lim J; Members of Veterans Affairs Hepatitis C Resource Center Program. Renal impairment after spontaneous bacterial peritonitis in cirrhosis: incidence, clinical course, predictive factors and prognosis. Sort P, Navasa M, Arroyo V, Aldeguer X, Planas R, Ruiz-del-Arbol L, et al. Antibiotic prophylaxis for the prevention of bacterial infections in cirrhotic patients with gastrointestinal bleeding: a meta-analysis. Llach J, Rimola A, Navasa M, Ginés P, Salmerón JM, Ginés A, et al. Underfilling of the arterial circulation in the decompensated state leads to vasoconstriction via the renin-angiotensin-aldosterone system and sympathetic nervous system, which results in sodium and free water retention by the kidneys (). Garcia-Tsao G, Lim JK, Lim J; Members of Veterans Affairs Hepatitis C Resource Center Program. Garcia-Tsao G, Lim JK, Lim J; Members of Veterans Affairs Hepatitis C Resource Center Program. Over its natural history, cirrhosis progresses from a compensated state to diuretic-responsive ascites to refractory ascites and finally to hepatorenal syndrome (HRS). Management and treatment of patients with cirrhosis and portal hypertension: recommendations from the Department of Veterans Affairs Hepatitis C Resource Center Program and the National Hepatitis C Program. Management and treatment of patients with cirrhosis and portal hypertension: recommendations from the Department of Veterans Affairs Hepatitis C Resource Center Program and the National Hepatitis C Program. The new onset of ascites in a patient with previously compensated cirrhosis should prompt referral to a gastroenterologist or hepatologist. Current management of the complications of cirrhosis and portal hypertension: variceal hemorrhage, ascites, and spontaneous bacterial peritonitis. Management of ascites - Cancer Therapy Advisor Draft Guidelines for the Management of Malignant Ascites. Cirrhotic Ascites - Cleveland Clinic CME
     
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