ASCITES AND RENAL FUNCTIONAL ABNORMALITIES IN CIRRHOSIS - PATHOGENESIS AND TREATMENT

In the past few years, there have been important advances in the field of pathogenesis and management of ascites and hepatorenal syndrome in cirrhosis. A new pathogenic theory of ascites and renal dysfunction i n cirrhosis has been presented and previously ill-defined conditions, such as refractory ascites and hepatorenal syndrome, have-been defined precisely. The link between the diseased liver and the disturbances i n renal function and vasoactive systems is not completely known, but a large body of evidence indicates that it consists of a circulatory dy sfunction that affects mainly the arterial circulation and is characte rized by an inability to maintain an effective arterial blood volume w ithin normal limits. The research on the mechanisms of this circulator y dysfunction will give valuable information in the design of more pat hophysiologically oriented therapeutic approaches to the management of ascites.