Ascites and hepatorenal syndrome

Ascites is a frequent complication of chronic liver disease with severe por tal hypertension, Moreover, in the presence of tense ascites, renal dysfunc tion and hepatorenal syndrome may occur, Unfortunately, there is no explana tion that thoroughly describes the complex relationship between the liver a nd kidney in either physiological or pathological conditions. Nevertheless, available evidence indicates that early sodium and water retention precede s decompensation, characterized by hyperdynamic circulation. The best appro ach to the treatment of these patients should be aimed at the prevention of ascites formation. An accurate sequential treatment is indicated in patien ts with ascites. In the case of hepatorenal syndrome, the only definitive a pproach is liver transplantation. Eur J Gastroenterol Hepatol 13:313-316 (C ) 2001 Lippincott Williams & Wilkins.