Dynamics of albumin in plasma and ascitic fluid in patients with cirrhosis

Background/Aims: To determine dynamics of albumin in plasma and ascitic flu id of patients with cirrhosis. Methods: Forty-seven patients were classified in four groups: I - patients without fluid retention; II - patients with ascites not resistant to subseq uent diuretic treatment; III - recompensated patients during diuretic treat ment; and IV - patients with diuretic-resistant ascites, Transvascular and transperitoneal albumin transports were quantified by I-131-/I-125-labelled human albumin. Results: TERp (i.e. the fraction of intravascular albumin (IVM) passing fro m plasma into the interstitial space per hour) was increased in all groups. In group IV patients the transport rate of albumin from plasma into the as citic fluid (TERPA) was significantly higher than the transport rate from t he ascitic fluid back into the plasma: TERAP (0.45 vs. 0.26% IVM/h, P < 0.0 02). In group II patients TERPA was similar to TERAP (0.27 vs. 0.25% IVM/h, ns). A direct correlation was found between TERPA and TERAP in both groups of patients (r = 0.78, P < 0.001). Conclusion: In non-resistant ascites, t here is a steady state between the transport of albumin into the peritoneal cavity and back into the plasma, but in resistant ascites the former trans port is elevated, Thus, local factors may be important to treatment of asci tes. (C) 2001 European Association for the Study of the Liver. Published by Else vier Science B.V. All rights reserved.